ACA Definitions

An employee that works at least 30 hours per week, on average. This includes all faculty, staff, working retirees, adjuncts, temporary staff, and non-work-study students. Beginning July 2015, Wake Forest is required to offer medical coverage to an employee that meets this definition of full-time employment. Determination will be made upon hire, during an employment status change, or after a prior measurement period.

An employee that works less than 30 hours per week. This includes all faculty, staff, working retirees, adjuncts, temporary staff, and non-work study students. Determinations will be made upon hire, during an employment status change, or after a prior measurement period.

An employee that works varying hours and for which the University is unable to determine reasonably expected hours in advance. This includes all faculty, staff, working retirees, adjuncts, temporary staff, and non-work study students. Determinations will be made upon hire, during an employment status change, or after a prior measurement period.

A period of time that allows the University to look back at the hours worked and determine eligibility for medical coverage.

• Ongoing employees: 12-month period, April 15 – April 14
• New hires: 11-month period, based on the hire date

A period of time that allows the University to perform administrative duties related to counting hours and offering coverage. This is usually four to six weeks and will take place after April 14 each year.

A period of time that an employee is offered medical coverage, if the eligibility criteria is met.

• Ongoing employees: 12-month period, July 1 – June 30
• New hires: 12-month period, based on the hire date

Premiums for employee only medical plan coverage must not exceed 9.5% of employee’s compensation.

An employment break of at least four consecutive weeks, during which an employee of an educational institution is not credited with hours of service.

A break in service service impacts the measurement period as follows:

• Break of less than 26 weeks without any hours of service: ACA requires the break period to be excluded from the measurement period.
• Break of 26 weeks or more: ACA allows the employer to treat the individual as terminated and rehired.
• Break of at least four weeks:* ACA allows the employer to treat the individual as terminated and rehired based on the “Rule of Parity.”

Assuming the break exceeds the number of weeks of employment immediately preceding the break, during which the employee was not credited with any hours of service.

An employer with at least 50 full-time employees.

The medical plan must pay at least 60% of the cost of benefits.