ACA Eligibility

If you are using the Affordable Care Act (ACA) Employee Eligibility program to create and maintain employee ACA eligibility statuses, you can incorporate the employee ACA eligibility status in benefits eligibility rules. To base an eligibility rule on the employee ACA Eligibility Status, you need to create an eligibility condition with the Method AE (ACA Eligibility). This method refers to an employee's current ACA Eligibility Status in the ACA Employee Eligibility table (F081161). With method AE in the Min Amount or Status field, enter the numeric value from the Special Handling column of the ACA Eligibility Status code (UDC 08/SE) on which the eligibility is based.

To work with ACA eligibility status for an employee, you must define a special handling code in the Min Amount or Status field that corresponds to an eligibility status defined in UDC table 08/SE. You also need to specify AE in the Method field.

The system uses the Effective Date from the benefits enrollment process to find the ACA Eligibility Status record in the ACA Employee Eligibility table (F081161). The system selects the record that has an eligibility date in the Eligibility Status Effective Date field nearest to, but less than or equal to, the effective date used in the benefits process. If the system finds more than one ACA eligibility status records in F081161 with the same date qualifying the records for selection, then the system uses the record with the latest parameter control number to determine the ACA eligibility status.