Affordable Care Act

ACA FAQ’s

How is eligibility in the High Deductible Health Plan determined?

  • Temporary employees, student workers (with the exception of Federal Work Study students) and adjunct faculty hired prior to January 1, 2015

    • The Affordable Care Act (ACA) provides that HR/Benefits measure the work hours of any non-permanent employee working for the University for a 12 month period to determine if they are averaging over 30 hours/week.  For example, if a temporary employee was hired on February 1, 2014, then in February, 2015, we would determine if the temporary employee averaged over 30 or more hours per week.  If so, this person would be eligible to enroll in the ACA health plan.

Action Month

October 1, 2014

November 1, 2014

Hire Date to "Measure" for 30 hours

Prior to 10/1/2013

10/1/2013-10/31/2013

Measurement Period

10/3/2013 - 10/2/2014

11/1/2013 - 10/31/2014

Enrollment Period

11/1/2014 - 11/30/2014

11/1/2014 - 11/30/2014

Coverage Period

1/1/2015 - 12/31/2015

1/1/2015 - 12/31/2015*

     

Action Month

December 1, 2014

January 1, 2015

Hire Date to "Measure" for 30 hours

11/1/2013 - 11/30/2013

12/1/2013 - 12/31/2013

Measurement Period

12/1/2013 - 11/30/2014

1/1/2014 - 12/31/2014

Enrollment Period

12/1/2014 - 12/30/2014

1/1/2015 - 1/30/2015

Coverage Period

1/1/2015 - 12/31/2015

2/1/2015 - 1/31/2016

     

Action Month

February 1, 2015

March 1, 2015

Hire Date to "Measure" for 30 hours

1/1/2014 - 1/31/2014

2/1/2014 - 2/28/2014

Measurement Period

2/1/2014 - 1/31/2015

3/1/2014 - 2/28/2015

Enrollment Period

2/1/2015 - 3/2/2015

3/1/2015 - 3/30/2015

Coverage Period

3/1/2015 - 2/28/2016

4/1/2015 - 3/31/2016

     

Action Month

April 1, 2015

May 1, 2015

Hire Date to "Measure" for 30 hours

3/1/2014 - 3/31/2014

4/1/2014 - 4/30/2014

Measurement Period

4/1/2014 - 3/31/2015

5/1/2014 - 4/30/2015

Enrollment Period

4/1/2015-4/30/2015

5/1/2015 - 5/30/2015

Coverage Period

5/1/2015 - 4/30/2016

6/1/2015 - 5/30/2016

     

Action Month

June 1, 2015

July 1, 2015

Hire Date to "Measure" for 30 hours

5/1/2014 - 5/31/2014

6/1/2014 - 6/30/2014

Measurement Period

6/1/2014 - 5/31/2015

7/1/2014 - 6/30/2015

Enrollment Period

6/1/2015 - 6/30/2015

7/1/2015 - 7/30/2015

Coverage Period

7/1/2015 - 6/30/2015

8/1/2015 - 7/31/2016

 

  • Temporary employees, student workers (with the exception of Federal Work Study students) and adjunct faculty hired on or after January 1, 2015

    • The Affordable Care Act (ACA) states that any non-permanent employee hired or rehired after January 1, 2015 working 30 or more hours per week for 3 months or more, must be offered the chance to enroll in the ACA health plan within their first 30 days of employment.

How will eligible employees be notified?

Non-Permanent employees will receive an email notification from the Benefits Office alerting them of their eligibility to participation the HDHP.

How does a non-permanent employee enroll in the HDHP?

Employees must go to: shphdhp.com to complete their registration and enrollment.\

Once an employee signs up, how long are they covered?

Employees are covered for the plan year.  If the employee is still employed at the time of open enrollment, then they would sign up for the next plan year. 

What happens if I accept another temporary assignment on campus?

The employee would still be eligible if they change departments, regardless if the assignment is less than 30 hours a week.  Once eligible has been determined for that plan year, the employee is still eligible for coverage.

Can I work more than one temporary assignment at a time?

Yes.  However, the departments will need to be aware of the number of hours the employee will work in each department.  If the employee works an average of 30 or more hours a week or 130 hours a month for at least three months, then the employee become eligible for health care coverage.  Now both departments and future departments will need to prepare for insurance coverage, if the employee accepts.

What are the resources that are available to non-permanent employees to help them understand the plan?

The following resources are available for eligible employees that are interested in learning more about this plan at: http://www.shpnc.org/HDHP.aspx Information on this site includes:

§  Enrollment Guide

§  Rate Sheet

§  HDHP Summary of Benefits

§  Employee FACT Sheet

§  2015 Express Scripts’ National Preferred Formulary

 

How does an eligible employee find a healthcare provider?

To find a provider within the MedCost network, visit Medcost.com, click “Locate a Provider” and select “MedCost/MedCost ULTRA” NOTE: Do not use the Find a Doctor icon found on the State Health Plan’s website.

What are the Monthly Premiums of the High Deductible Health Plan?:

The HDHP plan is a prepaid plan, which means employees will pay premiums one month in advance through a direct bill received from the billing administrator CobraGuard.   The rates are as follows:

 

Coverage Type

Employer

Employee

Dependent

Total Employee Cost

Employee Only

 $  117.62

 $          92.38

 N/A

 $                            92.38

Employee + Child(ren)

 $  117.62

 $          92.38

 $        169.78

 $                          262.16

Employee + Spouse

 $  117.62

 $          92.38

 $        376.56

 $                          468.94

Employee + Family

 $  117.62

 $          92.38

 $        470.56

 $                          562.94

 

Who can an eligible employee call for questions?

  • For questions about enrollment call the Enrollment and Billing Support Center at 855-442-6272.
  • For questions about the Pharmacy benefit, call Express Scripts Customer Service at 800-336-5933.
  • For general questions:  Gina Ewart at 704-687-0647 or Joy Finney at 704-687-0648.

Rehired Retirees

The General Assembly has enacted legislation that requires a rehired retiree to enroll in the High Deductible Health Plan and terminate their retiree health plan if they become eligible under the ACA for the non-permanent health plan.  HR/Benefits recommends that rehired retirees work no more than 29 hours per week.

Affordable Care Act FAQs

 

 

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