ACA Examples of Measurement Methods (article)
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For purposes of the employer shared responsibility provisions under the Affordable Care Act (ACA), an employee is deemed full-time if the employee works, on average, 30 or more hours per week. In many situations, an employee’s status upon hire is not clear. To this end, the final shared responsibility regulations issued in February, 2014 provide two methods: a monthly method and a look-back method that can be used for determining full-time status as it relates to the potential assessment of an employer shared responsibility penalty (see CBIZ Health Reform Bulletins, Exploring the Final Employer Shared Responsibility Regulations, 3/10/14 and Final Rules Addressing the Employer Shared Responsibility Requirement, 2/12/14). The final regulations also include several examples illustrating a variety of changes that can occur, for example, what happens when an individual moves from one employment position to another resulting in a change in measurement methodology. Following are examples of some of the common scenarios that could arise.
For purposes of these examples, the employer, “NewCo”, is deemed an applicable large employer employing 200 full-time employees (“FTE”, including full-time equivalent employees, “FTEEs”).
Example 1. Transition from Benefit-ineligible Position to Benefit-eligible Position
NewCo uses a monthly measurement method to identify FTEs and only offers health coverage to its FTEs and their dependents. In each month of Year 1, Sue is hired as a part-time employee, consistently working fewer than 30 hours a week (a benefit-ineligible position). In Year 2, Sue is transferred to a full-time 40-hour per week position (a benefit-eligible position). By April 1 of Year 2, NewCo offers minimum value health coverage to Sue. In this example, NewCo is not at risk for shared responsibility penalty as long as the minimum value coverage remains affordable since the coverage was made available by the first of the fourth month following the date Sue transfers to the full-time benefit-eligible position.
In Examples 2 and 3 below, NewCo uses a monthly measurement methodology for determining whether a salaried employee is a FTE. The look-back measurement period is October 15th through October 14th of the preceding calendar year; the stability period is the calendar year.
Example 2. Look-back Measurement Method to Monthly Measurement Method
Jane is an hourly employee. Based on her hours worked from October 15, 2015 through October 14, 2016, she is treated as a FTE for the 2017 calendar year. On July 1, 2017, Jane transfers from her hourly position to a salaried employee. For July 2017 through December 2017, she is treated as a FTE. Using the applicable look-back measurement method, based on Jane’s hours of work from October 15, 2016 through October 14, 2017, Jane is treated as a FTE for the 2018 calendar year. For the 2019 calendar year, the monthly measurement method would be used to determine Jane’s full time status.
Example 3. Monthly Measurement Method to Look-back Measurement Method
Frank is a salaried employee of NewCo. On July 1, 2017, Frank transfers to an hourly employee position. Based on his hours worked from October 15, 2015 through October 14, 2016, Frank would have been treated as a FTE for the stability period of the 2017 calendar year had the look-back measurement method (applicable to hourly employees) applied to him for the entire stability period. For the calendar months January 2017 through June 2017 (prior to the change to hourly employee status), Frank's status as a FTE is determined using the monthly measurement method. For the calendar months July 2017 through December 2017, NewCo must treat Frank as a FTE because he would have been treated as a FTE during that portion of the stability period had the look-back measurement method applied to him for that entire stability period. Under the applicable look-back measurement method based on hours worked from October 15, 2016 through October 14, 2017, Frank is treated as a FTE for the 2018 calendar year. For calendar year 2019, Frank’s FTE status is determined under the applicable look-back measurement method.
Example 4. New Variable Hour Employee - No Delay in Coverage - Becomes Non-FTE
NewCo uses a look-back measurement method to determine FTE status of all employees. On May 10, 2015, NewCo hired Rita as a variable hour employee. NewCo offers minimum value health coverage to Rita on September 1, 2015. For its on-going employees, NewCo uses a 12-month standard measurement period beginning October 15th and a 12-month stability period beginning January 1. Rita continues her employment with NewCo for over 5 years and averages over 30 work hours per week. On February 12, 2021, Rita changes her employment position to one where she’s working fewer than 30 hours per week. She has maintained health coverage during this timeframe of September 1, 2015 through May 31, 2021. Beginning June 1, 2021, NewCo elects to apply the monthly measurement method to determine Rita’s FTE status for the remainder of the stability period ending December 31, 2021 and calendar year 2022. Applying the stability period beginning January 1, 2021, NewCo treats Rita as a FTE for each calendar month from January through May, 2021. She is determined to be a non-FTE under the monthly measurement method for each calendar month from June 2021 through December 2022.
Because NewCo offered minimum value coverage to Rita by the first day of the 4th calendar month following her start date through the calendar month in which the change in employment status occurred, and because Rita didn’t average 30 work hours during the 3 calendar months following her change in employment status, NewCo can use the monthly measurement method to determine Rita’s FTE status beginning June 1, 2021 through the end of the first full measurement period (plus any administrative period) immediately following the change in employment status (December 31, 2022). Since Rita did not average at least 30 work hours per week during June 2021 through December 2022, NewCo has properly treated Rita as a non-FTE for those calendar months. Thereafter, Rita’s status will be assessed using the look-back methodology.
Example 5. Variable Hour Employee Transition from Initial to Standard Look-back Period
For purposes of this example:
Initial measurement period: May 1st to April 30th
Administrative Period: May 1st to May 31st
Stability Period: June 1st to May 31st
Joe is hired on May 1. He is determined to be a variable hour employee. An initial 12-month measurement period of May 1st to April 30th is used to determine his status. The initial measurement period is followed by a one-month administrative period, May 1 through May 31. Joe is deemed to be full-time based on hours worked during the initial measurement period. Joe’s initial stability period runs from June 1 through May 31. Coincident with the initial measurement period, Joe is measured during the first standard measurement period that arises after his date of hire. Joe is deemed full-time based on hours worked during the standard measurement period. Thus, Joe is deemed full-time during the standard stability period, a portion of which, January through May coincides with his initial stability period. In addition to being deemed full-time during the initial stability period, Joe is deemed full-time for the balance of the standard stability period, June 1 through December 31.
Example 6. Variable Hour Employee Transfers to FTE during Initial Measurement Period
For purposes of this example:
Initial measurement period: July 1 to June 30
Change in status waiting period: Jan 15 to April 30
Stability period: May 1 to April 30
Joe is hired on July 1 as a variable hour employee. His initial measurement period runs from July 1 through June 30. On January 15 (during the initial measurement period), Joe is moved to a new full-time position; thus, he is treated as a FTE on May 1. Because Joe experiences a change in status from variable hour to FTE during the initial measurement period, he is treated as a FTE by the first of the 4th month from the date of change in status.
Below are two examples relating to what happens when there is a change in measurement periods, based on the proposals contained in IRS Notice 2014-49 (summarized in CBIZ Health Reform Bulletin, Employer Shared Responsibility – Change in Employment Status Proposals, 10/6/14).
Example 7. Employer-initiated Changes in Measurement Methods for One or More Permissible Categories of Employees
As of January 1, 2015, NewCo employs one set of employees covered by a collective bargaining agreement (CBA) to which it utilizes a 6-month measurement and stability period, each beginning April 1 and October 1 for purposes of determining the full-time status of these CBA-employees. It uses a 12-month measurement and stability period beginning January 1 to determine the status of its remaining workforce not covered under the CBA.
On April 1, 2017, NewCo changes the look-back measurement method for the non-CBA employees to be the same as that used for CBA-covered employees. In the subsequent transition period following the date of this change, the status of non-CBA employees are treated as if they had transferred from a position subject to the original measurement method to a position subject to the revised measurement method. As such, non-CBA employees retain their full-time status as determined under the original measurement period for the remainder of the 12-month stability period. Non-CBA employees who were not in a stability period as of the date of change would have their status determined under the 6-month measurement method.
Example 8. Change in Position Resulting in Transfer to Different Look-back Methodology
An employer can use different look-back methodology for different categories of employees. These categories are:
- Collectively bargained and non-collectively bargained employees;
- Each group of collectively bargained employees covered by a separate collective bargaining agreement;
- Salaried employees and hourly employees; and
- Employees whose primary places of employment are in different states.
If a variable hour employee moves from a position for which the employer uses one look-back standard (for example, a calendar year look-back) to another position for which the employer uses a 12-month stability period (for example, July 1 to June 30), the rules provide that if an individual is in a stability or administrative period at the time of the transfer, the individual retains his/her status based on his/her first position (Position 1). At the end of the stability period, the individual moves to the measurement period for the second position (Position 2); but all hours worked during Position 1 are counted.
If an individual is not in a stability or administrative period for Position 1, for example, the individual is in an initial measurement period at the time of the transfer to Position 2, the individual is immediately moved to Position 2 methodology using all hours worked in Position 1.
Example: New variable hour employee in initial measurement period transfers to position in which employee has completed initial measurement period
- 12-month standard measurement and stability periods beginning January 1
- 12-month initial measurement period beginning on date of hire
- 6-month standard measurement and stability periods beginning January 1 and July 1
- 6-month initial measurement period beginning on date of hire
Tom, a new variable hour employee for NewCo begins working in Position 1 on January 1, 2015. He averages 30+ hours of service per week during January 1 through June 30, 2015. On October 1, 2015, Tom is transferred to Position 2. While his status is now determined under the Position 2 measurement methodology, the hours he worked in Position 1 are taken into account. Tom is determined to be a FTE from October 1, 2015 through December 31, 2015 because he averaged 30+ hours of service per week during Position 2’s measurement period ending June 30, 2014. After December 31, 2015, Tom’s status continues under Position 2’s applicable measurement period.
The information contained herein is not intended to be legal, accounting, or other professional advice, nor are these comments directed to specific situations. The information contained herein is provided as general guidance and may be affected by changes in law or regulation. The information contained herein is not intended to replace or substitute for accounting or other professional advice. Attorneys or tax advisors must be consulted for assistance in specific situations. This information is provided as-is, with no warranties of any kind. CBIZ shall not be liable for any damages whatsoever in connection with its use and assumes no obligation to inform the reader of any changes in laws or other factors that could affect the information contained herein.