How the ACA Eligibility Process Determines Employee Eligibility

The ACA Eligibility Process evaluates each employee to determine their eligibility and then updates their ACA assignment fields appropriately.

For further info, see ACA Eligibility Process in the Help Center.

Settings that affect this process

Your organization must be completely configured for the ACA Eligibility process to run accurately.

For further info, see Configure Affordable Care Act Reporting in the Help Center.

How it determines eligibility for new hires

When you run this process:

1. It identifies all active employee primary assignments that fall within the parameters you set when you start the process.

2. For each of these employees, it captures the following.

   • ACA Eligibility

   • Limited Nonassessment

   • ACA Full Time

   • Measurement Start Date

   • Measurement End Date

   • Administrative Start Date

   • Administrative End Date

   • Stability Start Date

   • Stability End Date

3. For each employee, it checks if their hire or rehire date is within the start and end date parameters you set.

4. If the person's hire date is in the process's date range, the process uses the Initial columns of the ACA Eligibility Attributes table.

   It uses the Ongoing columns of the table when:

   1. The person's hire isn't within the process's date range.

   2. One of their measurement, administrative, or stability end dates is within the date range.

   3. There are no other prohibitions as defined by the process's logic.

5. It checks each row in the ACA Eligibility Attributes table in sequence.

   • If the employee isn't eligible based on any of the criteria in the Eligibility table, the process skips them and proceeds to the next employee.

   • If it finds an eligibility match for that person, it uses the info in that row to determine the new values.

     The process notes these as being the new values for the assignment parameters listed above.

6. It uses the following to determine what updates are needed on the employee's primary assignment, if any.

   • Current values on the person's assignment as of the end date of the date range selected

   • New values determined based on the ACA Eligibility Attributes table

   • Additional process logic

7. If an existing employee has a status of Yes-weekly, Yes-monthly, No-weekly, or No-monthly, the process determines their new status.

   1. Sums the hours in the predefined ACA Employee Eligible Hours balance for the current measurement period's duration.

   2. Divides this sum by either the number of weeks or months in the measurement period, depending on the person's eligibility.

   3. It does the following.

      If the person's eligibility is	Then the process
      Yes-weekly	Determines the number of weeks in the measurement period. If the resulting average hours per week are greater than or equal to 30, it leaves their eligibility as Yes-weekly. Otherwise, it changes the eligibility to No-weekly.
      No-weekly	Determines the number of weeks in the measurement period. If the resulting average hours per week are greater than or equal to 30, it sets their eligibility to Yes-weekly. Otherwise, it leaves the eligibility as No-weekly.
      Yes-monthly	Determines the number of months in the measurement period. If the resulting average hours per month are greater than or equal to 130, it leaves their eligibility as Yes-monthly. Otherwise, it changes the eligibility to No-monthly.
      No-monthly	Determines the number of months in the measurement period. If the resulting average hours per month are greater than or equal to 130, it changes their eligibility to Yes-monthly. Otherwise, it leaves the eligibility as No-monthly.

8. If the ACA Eligibility process detects a change, it updates the primary assignment.

9. It generates audit and exception reports.