Measurement Period Flow Chart
Employers <50 FT
and FTEs
Employers
50 -99 FT
and FTEs
Eligible for
Transitional
Relief*
Employers
>100 FT and
FTEs eligible
for
Transitional
Relief*
FTE – Full Time
Equivalent Employees
Not Subject to
Employer Shared
Responsibility – no
need to Measure
Must offer coverage
to 95% of FTE to
avoid penalty. The
compliance date is
dependent upon
your 125 plan
document and plan
year
Must offer coverage
to 70% FT by 1/1/15
or 7/1/15 to avoid
penalty. Your
compliance date
depends upon your
125 plan document
and plan year (For
2016 plan years, the
requirement is 95%).
Measure variable hour
employees, whether
permanent or temporary,
if you do not offer them
coverage and you are not
certain whether or not
they are eligible for
coverage.
Measure variable hour
employees, whether
permanent or temporary,
if you do not offer them
coverage and you are not
certain whether or not
they are eligible for
coverage.
FT – Full Time Employee – 30
hours or more per week
Section 125
Plan Year
7/1/2016
Section 125
Plan
Year
1/1/2016
Section 125
Plan Year
7/1/2015
Section 125
Plan Year
1/1/2015
If your compliance date is 7/1/16 as per your
section 125 plan document then measure
from May 1, 2015 through April 30, 2016 to
make determinations and act accordingly. For
anyone hired after May 1, 2015, you will also
have to measure for a 12-month period based
on the employee’s date-of-hire.
If your compliance date is 1/1/16 as per your
section 125 plan document then measure
from November 1, 2014 through October 31,
2015. For anyone hired after November 1,
2014, you will also have to measure for a 12month period based on the employee’s dateof-hire.
If your compliance date is 7/1/15 as per your
section 125 plan document then measure
from May 1, 2014 through April 30, 2015 to
make determinations and act accordingly. For
anyone hired after May 1, 2014, you will also
have to measure for a 12-month period based
on the employee’s date-of-hire.
If your compliance date is 1/1/15 as per your
section 125 plan document then measure from
November 1, 2013 through October 31, 2014 to
make determinations and act accordingly. For
anyone hired after November 1, 2013, you will
also have to measure for a 12-month period
based on the employee’s date-of-hire.
* Most Vermont school districts are eligible for Transitional Relief. Please read VEHI Memo
on topic at www.vehi.org for further information and to confirm the status of your district.
Full Time Temporary Employees – these employees should be treated as full time if they are working over 30 hours per week- even
if it is anticipated they will work for a short duration [for example two weeks]. If there is no waiting period other than the first day
of the month after hire- see below- should be offering them coverage upon hire to take effect the first day of the next month after
hire. However, it is important to remember how penalties are calculated. As long as you are offering affordable coverage that
meets minimum value coverage to at least 95% of your workforce, you may still not be in a significant penalty position for failing to
make an offer of coverage. You may only be potentially subject to the $3,120 annual penalty ($260/month) per FT employee
receiving a tax credit for a limited number of months. Therefore, for someone working a short period of time, the possible penalty
may be less than the cost of coverage.
Waiting Period - as per BCBSVT, The earliest a new employee can enroll is the first of month after first day of hire. Under the
Affordable Care Act, an employer may add an additional waiting period of up to 90 calendar days. For instance, an employer may
have a different waiting period for its Union and non-union employees. We cannot provide a legal opinion regarding how an
employee is categorized. The district must determine whether a substitute falls within a specified category and determine whether
an offer of coverage should be made. It is important to establish a protocol, with a rationale, and apply that protocol consistently.
As best practice, and to minimize possible discrimination concerns, it is advisable to treat all new hires in the union category the
same in regards to waiting periods. As best practice, and to minimize possible discrimination concerns, all new hires in the nonunion category should be treated the same in regards to waiting periods. Waiting periods for union employees are generally subject
to collective bargaining.
November 2014 GALLAGHER BENEFIT SERVICES, INC.
The intent of this communication is to provide you with general information regarding the status of, and/or potential concerns related to, your
organization’s current employee benefits environment. It does not necessarily fully address all of your organization’s specific issues. It should not
be construed as, nor is it intended to provide, legal advice.