I work part time. My employer will no longer allow me to work over 26 hours per week to avoid the mandatory health insurance I’d have to receive from the corporation. Is that true? Also, if I was 65 & on Medicare, could I then work over 30 hours without causing my employer to have to pay for my medical insurance. I have insurance now, but it’s so expensive that now I have to find another part time job to pay for it as this job has reduced my hours to anywhere from 17-26 hours per week. This has affected a lot of people who work part time & wish to still earn money. And, yes, I am 62 using my Social Security checks to pay for insurance, but I still have other medical bills to pay as well. Then there’s a mortgage, utilities, & I could go on. How does this law help those of us who are older, but still have to work?? I don’t want to think I will never get ahead. How depressing would that be.
If an employee works at least an average of 30 hours a week, or 130 hours a month, they are considered full-time and large employers must offer health insurance to them under the law. By this same logic, if the employee works less than 30 hours a week, or less than 130 hours in a month, they are considered part-time under the law (for the purposes of being offered coverage).
- To be considered full-time, the employee must work more than 120 days in a year. Likewise, less than 120 days in a year is part-time. Also some employee types, like Adjunct employees don't have to be offered coverage.
- Many employers will keep the employee at 27 hours a week as a "safe harbor". This avoids the employee accidentally going over due to overtime.
- Only employers with 50 or more full-time equivalent employees (FTE) who have to comply with the mandate have to offer coverage to full-time employees or get a fine.
- Small employers with less than 50 FTE don't have to offer coverage (although some may still offer it anyway).
- If an employee or their dependents has access to employer coverage options (regardless of full-time status), then they can't get marketplace cost assistance.
Here are some additional notes:
There is no way for an employee to opt-out of being offered health insurance, if an employer has to comply with the mandate, and the employee works full-time, they must be offered coverage. There are some work arounds though.
For an employer to be fined, the employee must get cost assistance on the Health Insurance Marketplace. If an employee has Medicare, or makes too much to use the Marketplace, or simply doesn't use the Marketplace by choice then the employer won't get fined. This means the employer can offer coverage, the employee can decline coverage, and the employer won't get a fine and the employee won't qualify for the Marketplace.
The above being said, as a safe harbor, employers should always offer full-time employees coverage (even if they know they will decline). Not doing so would open the door for the employee to decide to get Marketplace coverage and thus the employer would be fined and the employer couldn't' stop them from doing this or take action like firing an employee for doing this.
Employers should also not offer reimbursement for individual health plans and should always offer group health plans (unless they have had assistance setting up a properly structured workaround).
It's important to note that employers only have to provide coverage to 95% of employees. So they CAN make exceptions for the 5%. That exception voids pretty much every rule above.
For more details on all of this one should read our page on the employer mandate.
NOTES: Two last things to note here are measurement periods and the 90 day waiting period. Measurement periods add some complexity regarding how employers measure hours and can affect when plans start and stop. The 90 day waiting period refers to the 90 days a new hire has to wait to get covered.