Skip to main content
Documentation
Documentation
Administrator Guide
Last Updated: 2023-06-23
Concept: Worker Eligibility for Affordable Care Act Benefits

Concept: Worker Eligibility for Affordable Care Act Benefits

Workday uses passive events to identify eligible workers, based on average hours, records, and measurement history for benefits according to Affordable Care Act (ACA) standards. Using the ACA Measurement Period Eligibility Rule, Workday can determine whether:
  • You must record a measurement period.
  • A worker's hours during a measurement period qualify the worker as full-time.
Workday displays the result in the
Qualified As Full-time Based On ACA Measurement Period
 field. The
If there is an effect on employee benefits?
 condition rule then determines whether to create a benefit event or not.
For ongoing workers, Workday determine eligibility for variable-hour part-time employees and uses Open Enrollment to offer them coverage. When you add the
Qualified As Full-time Based On ACA Measurement Period
 field to eligibility rules for the benefit group and plan, Workday considers those workers for open enrollment.

Record ACA History

Workday follows this logic to determine what to include in the history record.
  1. Identify workers using the ACA eligibility rule assigned to the passive event.
  2. Among the eligible workers, find any who have completed a measurement period. Example: Where today's date is later than the worker's measurement period end date.
  3. For those workers, if the start and end dates don't already exist in history for the:
    • Initial measurement period, then write an initial history record.
    • Ongoing measurement period, then write a standard (ongoing) history record.

Define the Full-Time Workers Eligible for ACA Benefits

Workday follows this logic to populate the
Qualified As Full-time Based On ACA Measurement Period
 field.
  1. Identify workers using the eligibility rule from the passive event.
  2. For each worker, evaluate the
    Qualified As Full-time Based On ACA Measurement Period
     field:
    1. Get the payroll hours applicable to the measurement period.
    2. Calculate
      Average Month
       or
      Average Week
      :
      • Average Month = total hours / # of duration months
      • Average Week = total hours / # of duration weeks
    3. On the
      Affordable Care Reporting Configuration
       task:
      • If
        Average Month
         ≥
        Standard for Paid Hours Per Month
        , or
      • If
        Average Week
         ≥
        Standard for Paid Hours Per Week
      Then the
      Qualified As Full-time Based On ACA Measurement Period
       field =
      True
      .
  3. If the
    Qualified As Full-time Based On ACA Measurement Period
     field =
    True
    , then run the
    If there is an effect on employee benefits?
     condition rule to determine whether to create a benefit event or not.