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Under the Patient Protection and Affordable Care Act (PPACA), some variable-hour employees become eligible for University medical insurance while remaining ineligible for the University¡¯s other insurance plan offerings. The University complies with federal PPACA requirements to provide medical insurance coverage to eligible employees and their dependents.

University Requirements

• Because the University is an employer with more than 50 full-time employees, it must offer medical insurance to employees and dependents up to age 26.
• Offer eligible variable-hour employees medical plan coverage if their average hours worked meets a 30 hour threshold during the measurement period.
• Notify employees of their medical insurance choices, including the federal Health Insurance Marketplace coverage availability.

Measurement Period

In order to determine if variable-hour employees meet the necessary threshold for eligibility, the University employs measurement periods to evaluate the amount of time worked. 

For academic appointments, every course credit hour equals 3.25 hours worked. This means a 3-credit-hour course is equivalent to 9.75 hours of work per week, or .24 full-time equivalent (FTE). 

New Hires

This is an 11-month measurement period that begins on the first day of the month after a newly hired, variable-hour employee begins work (unless hired on day one of a given month). For example, if your first day of work was June 16, 2023, your measurement period would run from July 1, 2023, to May 31, 2024.

The UM System measures an employee¡¯s work hours after this period to determine if they averaged 30 hours or more per week. If yes, the university notifies the employee that they have become eligible for university medical insurance via a written statement sent to their home address on file. The notification explains that the employee will be offered insurance for 12 months after eligibility.

Ongoing Measurement

The UM System offers medical insurance to eligible variable-hour employees for 12 months at a time, in accordance with the PPACA. The university re-measures variable-hour employees each year to be sure that these employees should continue to receive insurance in subsequent years.

The university¡¯s ongoing measurement period is the same for everyone, regardless of when each employee was first offered insurance. The period is October 3 of one year to October 2 of the next year (e.g., October 3, 2022, to October 2, 2023). The measurement period must total 52 weeks. Depending on how the dates above fall in the pay period, the beginning and end dates might shift.

How To Enroll  

• Newly eligible: Follow the instructions included in written statement you received to enroll via myHR during the specified enrollment time frame.
• Ongoing eligibility: You will receive a letter in the mail (usually mid-October) notifying you that you re-qualified for medical insurance and will have the option to make changes to your enrollments during Annual Enrollment. 

Becoming Ineligible

If an employee is enrolled in medical insurance and becomes ineligible for coverage, they will receive a written statement (delivered to the mailing address on file) indicating that they are eligible to be a COBRA participant  for up to 18 months. The university's COBRA administrator will send an enrollment packet. 

Request Eligibility Review

If an employee, supervisor or coworker believes an employee should or should not have been offered medical coverage, they may submit a request to review eligibility as follows:

1. Complete the Request for Review of Medical Eligibility Form (PDF).
2. Submit the completed form to the HR Service Center, Attn: HR Consultant, Benefits
3. HR confirms that they received your form.
4. HR reviews job data and worked hours.
5. HR issues their determination following the review.
6. If eligible, HR provides the employee with a form to elect coverage.
   • Coverage begins the first day of the month following the determination.