Define Your Affordable Care Act Break-in-Service Rules

The ACA Break-in-Service Attributes table determines how your organization handles Affordable Care Act (ACA) eligibility for employees who have been terminated and rehired.

Depending upon the length of time away from employment and the duration of their employment prior to termination, the employee may be eligible to retain their previous benefits status.

There are no defaults and no data validation.

• You must define at least one row for each ACA Eligibility profile you've defined.

• You must define sufficient rows to capture all employee cases.

• Assign lower priority numbers to the more-specific rules. This ensures the Break-in-Service process enforces those rules first.

  Note: You must ensure the best match has the lower priority. Once an employee is processed, they're ignored for subsequent rows, even if they meet those criteria.

To define the break-in-service rules for your organization:

1. Start the Manage Legal Entity HCM Information task from your implementation project

2. Open your legal entity for editing.

3. Under Legal Employer, click Federal.

4. In ACA Break-in-Service Attributes, click Add Row.

   For each eligibility profile, you must define sufficient rows to capture all possible benefits restoration and restart outcomes.

5. Define the following.

   Column header	What you do
   Priority	Set the order in which the Break-in-Service process evaluates the rehired employee. The process runs from lowest priority to highest. Set the priority order to align with the eligibility and row for each day range from lowest to highest.
   Eligibility Profile	Select the ACA Eligibility profile for this priority. If all employees follow the same rules, leave this null. For further info, see Configure Benefits for Affordable Care Act Reporting in the Help Center.
   Break Days Greater Than or Equal Break Days Less Than	These two fields define the length of the break-in-service period for this benefits restoration outcome. Break Days Greater Than or Equal represents the number of days since the person's termination. The value you enter for Break Days Less Than must be greater than or equal to the value for Break Days Greater Than or Equal.
   Service Greater Than or Equal to Break	Select one: Yes: Employee’s length of service immediately prior to the break is greater than or equal to the duration of the break. No: Length of service immediately prior to the break is less than the duration of the break. Null: Don't consider.
   Result	For employees that meet these criteria, identify their ACA eligibility. Restore: Uses their eligibility prior to the break. New Hire: Treats them as a new hire.
   Assignment ACA Field Start Date	If you selected the Restore result, select when their restored eligibility begins. First of month: First day of the month following the date of hire. Hire date: Date of employee rehire. Start date of next pay period: First payroll period start date following the date of rehire. Start of pay period hire or next: Rehire date if the same as a pay period start date, else the next pay period start date. Start of month hire or next: Rehire date if the same as the first day of the month, else the first day of the month following date of hire.

6. Save your work.

7. Repeat until you've defined sufficient rows to capture all possible benefits restoration and restart outcomes for every eligibility profile.