How does the State Determine Eligibility - Affordable Care Act

The State of Idaho determines eligibility for its employees by using the Look-back measurement method.

 

There are 2 types of look-back measurements methods:

1. Initial Period - for New Employees

2. Standard Periods - for Ongoing Current Employees

 

The look-back method is comprised of 3 parts:

1. Measurement Period​

2. Administrative Period

3. Stability Period

During the measurement period the State of Idaho will measure employee hours of service to determine whether the employee is full-time.

Agencies are required to offer Tier 1 insurance to any employee identified as full time. The employee will remain eligible for Tier 1 insurance coverage during the entire stability period.

 

Health Coverage

Insurance will continue to be paid a month ahead of coverage. Please see look-back dates for coverage months.

Note: Remember sweep deductions (918 and 919) will be taken for employees eligible for insurance, regardless of whether or not they enroll for coverage.

 

State Benefits

The Look-back method is only used to determine eligibility for Tier 1 insurance per ACA rules.  Eligibility for other state benefits (PERSI, leave accrual, holiday pay, part-time insurance) may vary. 

 

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