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Administrator Guide
Last Updated: 2023-06-23
FAQ: Patient Protection and Affordable Care Act

FAQ: Patient Protection and Affordable Care Act

How does Workday determine who gets a 1095-C form?
Full-Time Employees that have weekly scheduled hours of 30 hours or more at any point in the calendar year. You can configure the number of hours on the Affordable Care Reporting Configuration page.
Employees that qualify as Full-Time (FT) if the ACA Measurement Period field value has been Y at any point during the calendar year. This group is your part-time population who you don't automatically offer medical coverage. They’re measured to evaluate eligibility over a measurement period.
Part-Time Employees who don't qualify as ACA FT, and enroll in coverage under a self-insured plan.
Part-time employees receive a form if they’re ACA FT-qualified, or if you offer them coverage in a fully funded plan.
How does Workday determine for ACA that a worker is full-time employee?
Workday considers a worker as full-time if:
  • Scheduled Weekly Hours
     is greater than or equal to the
    Standard for Paid Hours Per Week
     on the
    Affordable Care Reporting Configuration
     task. Workday reads these values on the first and last days of each month.
  • The worker has completed a measurement period, and the actual hours were greater than or equal to the
    Paid Hours Standard
    .
How does Workday calculate Average Monthly and Weekly Hours?
If you select the
Use Scheduled Hours for Exempt Workers
 option on the
Affordable Care Reporting Configuration
 task, Workday:
  • Uses this formula to calculate average monthly paid hours:
    # Of Weeks within Date Range rounded to nearest 100th * Worker's Weekly Scheduled Hours / # Of Months within Date Range
  • Uses this formula to calculate average weekly paid hours:
    # Of Weeks within Date Range rounded to nearest 100th * Worker's Weekly Scheduled Hours / # Of Weeks within Date Range rounded to nearest 100th
If you select the
Use Actual Payroll Hours for Exempt Workers
 option, Workday:
  • Uses this formula to calculate average monthly paid hours:
    # Of Hours within Date Range / # Of Months within Date Range
  • Uses this formula to calculate average weekly paid hours:
    # Of Hours within Date Range / # Of Weeks within Date Range rounded to nearest 100th
Workday determines the:
  • Worker's Weekly Scheduled Hours from the position or job.
  • # Of Months within Date Range from the End Date - Start Date, rounded up to the month.
  • # Of Weeks within Date Range rounded to nearest 100th from the End Date - Start Date / 7.
  • # Of Hours within Date Range from Workday Payroll plus any imported hours.
How does Workday Payroll or Payroll Interface coordinate with ACA requirements?
When using the lookback method to determine employees full-time status (30 hours per week or 130 hours per month), you must:
  • Workday Payroll: Configure the ACA measurement period. Map both paid hours worked and paid hours not worked from Workday Payroll results.
  • Payroll Interface: Import paid hours worked and paid hours not worked from an outside source.
To populate Form 1095-C, lines 14 and 16 correctly, Workday must accurately detect employees in an initial measurement period. An initial measurement period, known as a limited nonassessment period by ACA, is for these types of employees:
  • Variable-hour, part time.
  • Newly hired, full-time in a 3-month waiting period.
How does Workday determine if an employee received an offer of coverage for each month?
Workday uses the benefit event history to determine when the employee received an offer for medical plan coverage.
How does Workday determine if the benefit plan meets ACA requirements?
Workday determines a benefit plan meets ACA requirements if:
  • It's a medical coverage plan.
  • The
    Funding Method
     is
    Fully-Funded
     or
    Self-Insured
    .
  • The plan provides the
    Minimum Essential Coverage
    .
  • The
    Minimum Value Coverage
     applies to the employee, the spouse, or dependents.
How does Workday process rehired workers?
If you terminate and rehire a worker, Workday checks for a 13-week gap. For educational organizations, Workday uses a 26-week gap.
  • If the gap is greater than or equal to 13 weeks, then Workday processes the worker as a new hire.
  • If the gap is less than 13 weeks, Workday processes the worker as a rehire. If there’s payroll data that supports their eligibility for benefits, then Workday resumes regular benefit processing with the condition rule:
    If there is an effect on the employee benefits?
     This condition rule determines whether or not to create a benefit event, enabling the worker to enroll in benefits.
How do I handle adjunct faculty who work 10 months of a 12-month measurement period?
If an employee has any of these types of unpaid leave with unrecorded hours, you must account for the unrecorded hours:
  • The Family and Medical Leave Act of 1993.
  • Uniformed Services Employment and Re-employment Rights Act of 1994.
  • Jury duty.
  • Educational institutions with lapses in employment of at least 4 consecutive weeks.
Set up earnings and the related calculations to retrieve hours of service from Workday Payroll or Payroll Interface. Make sure to include lapses in employment that you want to account for in the
Workday Payroll Hours Source: Payroll Calculations
 section on the
Affordable Care Reporting Configuration
 task.