The State of Idaho is using the look-back Method to determine eligibility for full-time employees for the Affordable Care Act. The look-back method is comprised of 3 parts:
1. Measurement period
2. Administrative period
3. Stability period.
New employees must complete an Initial look-back period prior to participating in the Standard look-back period. The effective dates for the initial look-back, administrative, and stability periods will be based on the first pay date hours of service that are entered.
1. Initial Measurement Period
The process of determining eligibility begins with the "Initial Measurement Period". This is an 11 month period in which the employees hours of service are recorded. At the end of the measurement period, the employer will review and determine full-time status by averaging the number of service hours each pay period. If the employee reported an average of 130 hours of service per month during the measurement period, then the employer is required to offer Tier 1 insurance during the stability period.
For new employees the State of Idaho uses the pay period begin date of the second payroll that the employee has ACA hours of service as the start date (provided that ACA hours were coded during the first pay period).
During the measurement period it is possible employees will take non-paid leaves of absence; Please refer to breaks in service and eligibility examples for more information regarding these unique scenarios.
2. Initial Administrative Period
The next step in the process is the "Initial Administrative Period". This period of approximately two months allows time to update employees insurance eligibility. Meaning, agencies will be required to update the Employer Deductions form for all part-time employees who were determined to be full-time during the measurement period. These employees will be required to be offered Tier 1 insurance.
Note: Agencies may also change the eligibility or tier for those full-time employees who were determined to be part-time during the measurement period, however it is not required.
For more information on agency requirements and responsibilities go to "What is required from the Agencies".
3. Initial Stability Period
The final step is the "Initial Stability Period". This period is 12 months long and is directly following the administrative period.
If an employee was determined to be full-time during the preceding measurement period, the employee MUST be offered Tier 1 insurance for the entire stability period. Employers cannot change a full-time employee's tier for the full stability period.
When does a new employee start on the Standard Look-back Period?
All new employees will participate in the initial look-back period, however at the same time the standard look-back period is already in process.
On the first day of the standard stability period, the system will look to see what was the determined eligibility/tier for the new employee during the standard measurement period. If it is determined that the employee was:
1. Tier 1 insurance eligible: The new employee will no longer participate in the initial look-back, and will from then on be on the standard look-back period.
2. Tier 2 or No Tier insurance eligible: The new employee will finish their initial stability period. Once the initial look-back has been completed, the new employee will then immediately participate in the remaining standard stability period.
Initial Look-Back Period Dates
Eligibility Example
Return to Affordable Care Act