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Administrator Guide
Last Updated: 2023-06-23
Steps: Set Up Affordable Care Act Measurements and Eligibility

Steps: Set Up Affordable Care Act Measurements and Eligibility

To determine a worker's Affordable Care Act (ACA) benefit eligibility, Workday uses earning codes to retrieve hours of service from Workday Payroll or Payroll Interface. If you don’t use Workday Payroll, you can load hours using the
Affordable Care Act Workers Hours And Wages
EIB.
Set up earnings for:
  • Paid hours worked.
  • Paid hours not worked: vacation, personal leave, sick, FMLA, jury duty, military service.
  • Adjunct faculty hours for unpaid hours not worked: FMLA, USERRA, jury duty, educational institution leave.
To ensure accurate codes:
  • For line 14, map the configured spouse relationship type as
    Spouse
     in the
    Map Relationship to Workday
     field of the
    Maintain Related Person Relationships
     task.
  • For line 16, configure safe harbors in Workday.
Define the standards and other parameters Workday uses to identify and create benefit events for eligible workers.
Workday uses the look-back measurement method to identify full-time workers according to ACA standards.
  2. Edit Domain Security Policies.
    Set up the security policy for the
    Affordable Care Act (ACA) Administration
     domain in the Benefits functional area.
  3. For
    Health Care Coverage Types
    , select the
    Medical
     check box to indicate which coverage types you want Workday to consider as medical.
  4. Create an
    ACA Measurement Period Eligibility Rule
     that defines the workers you want to measure. You might want more than 1 rule. Example: You can create rules for:
    • Collectively and noncollectively bargained workers.
    • Salaried and hourly workers.
    • Workers located in different states.
    Don't use the
    Qualified As Full-time Based on ACA Measurement Periods
     report field in your new
    ACA Measurement Period Eligibility Rule
    .
  5. Access the
    Edit Benefit Eligibility Rule
     task.
    Modify the existing benefit eligibility rules for benefit groups and plans offered to ACA-eligible workers (including variable and hourly workers).
    Security:
    Set Up: Benefits
     domain in the Benefits functional area.
  6. For Payroll Interface users only, load payroll data using the
    Put Affordable Care Act Worker Hours And Wages
     web service.
    Enter 1 row for each payslip.
  7. Create a measurement period for new hires and ongoing workers. You need a measurement period for each group of workers that has an ACA measurement period eligibility rule.
  8. Create a benefit event to use in a passive event rule that sets the measurement period for workers using these criteria:
    • Enrollment Offering Type
      : Medical.
    • Days to Enroll Calculation
      : Initiate Date.
    • Days to Enroll
      :
      Configure this option based on the administrative period configured on the measurement period. The configuration depends on when coverage should begin: either on the first of the month after gaining eligibility, or after a waiting period.
      Set to 31 if the initial measurement administrative period is zero. Coverage begins on the first of the month, following the end date of the measurement period.
      Set to 1 if the initial measurement administrative period is 31 days, so that the submit by date equals the event date.