ACA Profile for Employees Overview

The ACA Profile provides a snapshot of the employee's Measurement Periods, Employee Status History, Coverage, and 1095-C Form. The ACA Profile gives the user the ability to view measurement periods, log employment changes (i.e. part time to full time), offer medical coverage, and view and email individual 1095-C reports.

From this page, you can access the following tabs:

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Definitions

  • Administrative Period (0-90 days)
    • Designated period to begin at the end of the measurement period, used to allow the employer time to process the measurement period and offer coverage to qualified employees.
  • Federal Poverty Level (FPL)
    • Set minimum amount of gross income required that a family needs for clothing, food, transportation, shelter, etc... The FPL in 2016, contiguous states, for a single person is $11,880 (Alaska $14,840, Hawaii $13,670).
  • Initial Measurement Period (3-12 months)
    • Designated period to observe and determine the status of newly hired individuals that have unpredictable hours, such as seasonal and variable hour employees.
  • Minimum Essential Coverage (MEC)
    • The type of health coverage an individual must have to meet the individual responsibility mandate under the Affordable Care Act. Coverage through employment, Medicare, Medicaid, TRICARE, Children’s Health Insurance Program (CHIP), and some other programs meet this requirement.
  • Minimum Value (MV)
    • The plans share of the total allowed cost of benefits must be at least 60% to be considered Minimum Value.
  • Self-Insured
    • A plan where the employer assumes direct financial responsibility for the costs of enrollees’ medical claims. Employer sponsored self-insured plans typically contract with a third-party administrator or insurer to provide administrative services for the plan.
  • Stability Period
    • The stability period begins immediately following the measurement period and the administrative period. This designated period must be the greater of six months or the measurement period for full time employees. If the employee is part time, the stability period cannot exceed the measurement period.
  • Standard Measurement Period (3-12 months)
    • Designated period used to determine if an ongoing (opposed to newly hired) variable or seasonal employee is full time and eligible for health care coverage.
    • Employers may have different measurement periods for:
      1. Collectively bargained and non-collectively bargained employees
      2. Salaried and hourly employees
      3. Employees of different entities
      4. Employees located in different states
  • Qualified Health Plan (QHP)
    • A medical plan that provides essential health benefits and follows established limits on cost-sharing (like deductibles and co-payments). Under the Affordable Care Act, qualified health plans will be certified by the Health Insurance Marketplace (HIM) through which they are sold.
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