Friday, March 3 2017

TO:     Business Officers, Administrative Assistants and PPS Preparers
FR:      Lisa Romero, Benefits Manager, Human Resources
RE:      Benefits Eligibility Rules-Reminder

On January 1, 2016 UC implemented new eligibility rules as part of the Employer Shared Responsibility provisions of the Affordable Care Act (ACA).  This required significant changes to the University’s benefits eligibility rules including the expansion to classes of employees previously considered ineligible, including:

Students employed under appointment type “casual-restricted.” (Hours paid under Federal Work Study programs are excluded from the 30 hours/week average calculation.)

Graduate Student employees

Staff employed under “per diem” appointments

Academic, staff, and students employed and paid under a flat rate amount arrangement such as BYA, SST or SSC.

Important reminders:

Eligible employees who do not take action to enroll will not be provided with default coverage.

Employees paid flat rate amounts such as BYA, will need to add a BYH distribution with a percentage of time in order to allow for crediting of hours.

Eligibility should be evaluated any time a new appointment is entered in PPS and when there is a change to an existing appointment.

Eligibility is based on cumulative appointments.

Eligibility can be gained at any time as the result of changes to the appointment.

Loss of eligibility should occur annually as the result of the Standard Measurement Period. There are some circumstances that may result in a loss of eligibility prior to the SMP however these situations should be in consultation with HR/Benefits.

The Standard Measurement Period measures employees for continuing eligibility and occurs annually, in November.

Revised rule- Group A employees who transition to a “WOS” appointment (with no other paid appt) will be considered Group B and will not have the option to continue some or all of their benefits.  It is important that the employee consult with HR/Benefits regarding these actions as it may also affect UCRP membership.

Please refer to the following link for additional resources and information https://www.hr.ucsb.edu/hr-units/employee-services/benefits-health-wellness-finances-retirement

Thank you.