The Patient Protection and Affordable Care Act, or Affordable Care Act (ACA), is the health care reform law. A piece of the Affordable Care Act is the Employer Shared Responsibility. This mandate requires all applicable large employers (50 or more employees) to offer affordable medical insurance to their ACA full-time employees.
The State of Idaho is required to participate in this federally mandated program. After discussions with the Division of Human Resources, the Office of Group Insurance, and the Division of Financial Management, it was decided the State Controller's Office would be responsible for all federal reporting requirements. The Office of Group Insurance is also heavily involved in ensuring that state employees are offered affordable insurance as well as determining what is considered affordable.
Note: For ACA determination purposes only, BSU, ISU and U of I (and any other government agency not paid by the State Controller's Office) are considered separate employers and work performed at those agencies is not included when determining ACA full time status. Government agencies not paid by the State Controller's Office are responsible for their own ACA determinations.
1. ACA only refers to the offer of coverage. Essentially eligible employees must be offered Tier 1 insurance, however that does not mean the employee is required to enroll. It is only mandated that the insurance has been offered.
2. The ACA requires employers to offer coverage for health insurance only. It does not include vision or FSA or other types of health care products. However, the Office of Group Insurance rules require that when health insurance is offered, dental and life insurance must be offered also.
3. Eligibility for other state benefits (PERSI, leave accrual, holiday pay, part-time insurance) are not mandated by ACA.
What is considered Affordable?
The Office of Group Insurance (OGI) is responsible for determining what insurance is considered affordable. To do so, they are utilizing the Federal Poverty Line Safe Harbor.
The Federal Poverty Line Safe Harbor: The employer's offer of coverage to an employee is treated as affordable if the employee's required contribution for the calendar month for the lowest cost self-only coverage that provides minimum value does not exceed 9.5% of a monthly amount determined as the federal poverty line for a single individual for the applicable calendar year, divided by 12.
The only insurance that the state currently offers that falls under this definition as affordable is Tier 1 insurance.
Note: An employee can have Tier 2 insurance, however it is not considered affordable under the Federal Poverty Line Safe Harbor, and therefore does not meet ACA requirements.
The ACA requires that the insurance plan is not only affordable but meets Minimum Essential Coverage and Minimum Value as defined by ACA. OGI has determined the State's insurance plan meets these requirements.
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