Employers Still Need to Heed ACA Obligations

So far, Congress hasn’t lifted health insurance requirements under the Affordable Care Act. 

March 24, 2020

ALEXANDRIA, Va.—As the convenience and fuel retailing industry prepares workforce and human resources plans for the new reality of the COVID-19 virus pandemic, the NACS government relations team urges retailers not to lose sight of obligations that may come up under the Affordable Care Act. So far, none of the legislation passed by Congress to respond to the national emergency has included language relaxing those requirements on companies with at least 50 full-time equivalent employees.

One scenario that may come up is when a part-time employee, who does not currently qualify for an employer health insurance plan, picks up significantly more hours than usual filling in for co-workers who become ill or need to take care of ill relatives. If that employee works more than 30 hours in a given week, it could trigger a requirement that employers offer them health insurance coverage.

Much of the specifics on whether or not such a scenario would trigger an obligation on the employer’s part depends on the specific definitions and terms of your health care plan. Retailers should check with their legal counsel on this question to verify their obligations. 

For general review purposes, NACS posed this question to our employment counsels at Fisher Phillips and received the following:

The general ACA rules are as follows for applicable large employers (those with an average of at least 50 full-time employees/equivalents in the prior calendar year—2019):

  1. In order for a large employer to avoid ACA excise taxes, ACA-compliant coverage must be offered to “full time employees”—those averaging 30+ hours of service per week or 130 hours of service per month.   
  2. Coverage is required on a month-to-month basis.
  3. When a current employee’s hours are variable and trending upward, the rules governing how quickly an employer must offer coverage is determined under the rules of the particular health plan. The rules for determining full-time employee status under the ACA are complicated and plan specific. Generally, they specify that coverage will be offered to the employee for the “stability period” that follows the applicable “measurement period” where the employee worked full time.  
  4. Hours of service an employee performs for members of a controlled group are counted.
  5. Hours for which an employee is paid, or entitled to payment for performance, are counted.
  6. If an employee is non-hourly, employers may calculate service based on actual hours worked, for which payment is due, or via an equivalency method, as specified in the plan.
  7. If an employee is paid hourly, employers use actual hours of service.

Again, these are general descriptions of the requirements under the Affordable Care Act and not a specific legal determination of what your specific plan may require nor does this general description include permitted variations or exclusions. NACS recommends that you speak with your own legal counsel if this scenario or others are possible to avoid any sanctions you may accidentally be subject to. 

NACS is here to help our members. If you are a NACS member and have questions on this scenario or others you may come across, reach out to Jon Taets, director, government relations, at jtaets@convenience.org