Understanding ACA Eligibility Status for an Employee
As an HR administrator, you use the Work With ACA Employee Eligibility program (P081161) to review employee eligibility information created by the Hours of Service report or to add or modify eligibility records. This status determines whether an employee is eligible for benefits coverage and should be offered coverage. From this form, you can review only the information that is not archived in the system. The eligibility information includes ACA eligibility status, eligibility effective date, record origination, average service hours, service hours work period, calculation method, measurement weeks, measurement period begin and end dates, administration period begin and end dates, and stability period begin and end dates. Additional employee master information is also included with the eligibility record to track information about the employee at the time the record was created. You can use the current eligibility status of the employee and the eligibility effective date to determine eligibility for benefits enrollment.
When you run the Work with ACA Employee Eligibility Status program, the system retrieves ACA eligibility information from the ACA Employee Eligibility table (F081161). If you make any changes to the information, the system updates the F081161 table. You can change records in the following way:
Computer-generated records: When the ACA employee eligibility records are created by the Hours of Service report, the system assigns them a value of C in the Record Origination field. You can update only the employee eligibility status for such a record, if it is a current record. Otherwise, you cannot update the computer-generated records.
Manual records: When the ACA employee eligibility records are manually created, the system assigns them a value of M in the Record Origination field. You can update eligibility status only for current records. However, you can update other details for both current and non-current records.
To update only eligibility status for a record, you need to select the current record and make the change. To update a record for details in addition to the eligibility status, you use the ACA Employee Eligibility Revisions program (P081161A). Access the ACA Employee Eligibility Revisions program from the Row menu on the Work with ACA Employee Eligibility program.
You cannot modify the archived information. In the ACA Employee Eligibility Revisions program, you can change eligibility status for a single employee only if the record is flagged as the current record in F081161. You can modify the employee eligibility information based on the value in the Record Origination field that represents whether a record is manually created or is a computer-generated record. For a manually created record, you can modify details in these columns:
ACA Eligibility Status
Eligibility Status Effective Date
Total Measurement Period Hours
Number of Measurement Weeks
Number of Measurement Months
New/Ongoing
Note: The Hours of Service report determines the employee category as new or ongoing based on the Date Started for the employee. If the Date Started is within the measurement period, the system classifies the employee as new and if the employee's Date Started is less than the measurement period start date, the system classifies the employee as ongoing.
In addition, when you manually add a record, the system populates various fields on the ACA Employee Eligibility form of the Work With ACA Employee Eligibility program on the Employee Detail tab from the Employee Master table (F060116). You can update the values in these fields, if required. The basic purpose of saving this information from F060116 for an employee is to capture the state of the employee at the time the eligibility record is created. The fields that the system populates from F060116 are:
Original Hire Date
Date Started
Pay Status
Employment Status
Benefit Group
Benefit Status
Home Company
Home Business Unit
Job Type
Job Step
Union Code
Pay Class
Work Tax Area
Residence Tax Area
For more details on the values to be entered in these fields, see Adding or Updating ACA Employee Eligibility Details.