Affordable Care Act Information for Boulder Grad Students
General Information
This is the federal law that is often referred to as the Affordable Care Act (ACA) and nicknamed "Obamacare" by many. Among its provisions is the “employer mandate” which requires employers with more than 50 employees to offer employer-sponsored health care to certain employees and their dependent children or to pay an assessment for not doing so.
Beginning in January 2014, the ACA required individuals to secure “minimum essential coverage” (as defined by the ACA), qualify for an exemption from this requirement, or pay a penalty when filing their income taxes. .
Employees who are expected at their hire date to work an average of 30 or more hours per week or who work an average 30 or more hours per week during a measurement period (defined by the University in compliance with ACA regulations) must be offered employer-sponsored health insurance that is compliant with the ACA - meaning that the insurance offers a minimum level of benefits. These employees' dependents must also be offered coverage. Dependents include children, stepchildren, and foster children. It is important to note that spouses and partners are not considered dependents under the ACA.
Employment Measurement Methods
To determine whether an employee is eligible for employer-sponsored health care, the university will use different measurement methods for salaried and hourly employees. The university will use the monthly measurement method for employees with salary appointments, and the look-back measurement method for hourly employees.
The ACA does not make a distinction between students and non-students. It is the 30 hour per week that triggers ACA requirements regarding employer-sponsored coverage.
In order to avoid the payment of an assessment, employers are required to offer employer sponsored coverage to employees, including student workers, who qualify. Employees are not required to accept coverage. As many Boulder graduate students may have coverage through other sources - the Student Gold Health Insurance Plan, spouses' insurance plans, parents' insurance plans, or other coverage - they may elect to not participate and therefore, would not pay the employee portion of the premium for the employer-sponsored health insurance.
Yes. Graduate students are required to have health insurance and are automatically defaulted into the Student Gold Health Insurance Plan unless they can show proof of other coverage. Details about the Student Gold Health Insurance Plan. Most graduate students employed as student faculty (TA, GRA, GPTI, GA) receive a substantial contribution from the university towards the cost of this coverage. Note that if a student is enrolled in the Student Gold Plan during the spring semester their coverage extends through the summer at no additional cost.
Yes, Boulder’s Student Gold Health Insurance Plan satisfies the ACA’s individual mandate. However, while the Student Gold is a very high quality plan, it is not considered an employer sponsored plan. As a result, if a student employee is expected to work 30 or more hours per week or averages 30 or more hours of work per week during a single month he/she will be offered coverage under the University’s employee plan (in addition to being eligible to enroll in the student health plan).
No. Graduate students are only allowed to work up to 20 hours per week during the AY unless they receive special permission. Therefore, it is unlikely that during the AY there will be more than a very small number of students who will meet the 30 hour minimum limit.
If a student is appointed to a position of 30 hours a week or greater than they will be eligible for employer-sponsored healthcare. It is important to note that they will only remain eligible during the months that they are working at this level, and thus at the end of the summer they would fall out of eligibility.
Questions Addressing Particular Student Situations
You do not have to enroll in the employee plan (if offered to you), and you do not have to enroll in the student plan. If you are under age 26, you may stay on your parents’ health care plan even though has offered you coverage.
Yes, for the months that you are eligible. Some of the plans you will be offered as an employee may provide more benefits, but the employee share of the premium will typically be more expensive than that for the student plan. Remember, if you had Student Gold insurance in the spring you remain covered during the summer months.
No. A person must work for a single employer for 30 or more hours per week in order to be covered by the ACA requirement to offer health insurance. Note that the University of Colorado system is considered a “single employer,” so if you are working on multiple campuses the total of all your appointments will be used to determine eligibility.
This is a complicated and personal choice. Under the Affordable Care Act, all persons – citizens or not – must enroll in health insurance coverage or pay a penalty on their taxes. We recommend that you compare the costs and levels of coverage of the Student Gold Health Insurance Plan, ’s employee plans and any equivalent plans available through the Health Insurance Marketplace (“Exchange”).
Yes! Please respond to Employee Services whether or not you wish to enroll in one of the plans.
You will no longer be eligible for employer sponsored health insurance starting with the first month after dropping below 30 hrs/week.