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Avionté ACA Companion - High-Level Workflow

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ACA Process for New Employees

This section provides an overview for setting up ACA coverage for employees hired or placed on an initial assignment beginning on, or after, January 1, 2015.

 

Full-Time Employee: 30 or more service hours per week

  1. Upon the new employee's first assignment, set the employee ACA Eligibility status in the core application. If you do not set up the employee's ACA Eligibility status prior to assignment, a DRM message will be generated notifying you to do so at time of assignment.

  2. The employee enters an administration period. When the employee becomes full-time (a Yes for ACA Eligibility), they are added to the ACA Full-Time without Offer counter. 
    • Once an employee has been offered coverage, be sure to record that offer in the Employee Plan Details tab of the ACA Companion Application. Once the offer has been added, the employee will fall off the ACA Full-Time without Offer counter. 
    • If the employee accepts coverage, add his or her Enrollment to the Offer entered in the ACA Companion Application.
    • If the employee declines coverage, add his or her Declination to the Offer entered in the ACA Companion Application.

  3. The employee now enters the standard measurement period, and if they are full time, they also enter into a stability period.
    Note: Coverage cannot be removed at this time.

  4. At the end of the standard measurement period, the employee is again evaluated for full-time status.
    • If the employee is found to be full-time, the employee retains coverage and is now part of the standard measurement and determination rotation which continues as long as he is employed.

    • If the employee is found to be less than full-time, the employer can elect to drop coverage for that employee. The employee is now part of a standard measurement and determination rotation. This rotation continues as long as he is employed.

 

Variable Hour Employee: 29 or less service hours per week

  1. Upon the new part-time employee's first assignment, set his ACA Eligibility status to No. If you don't set the ACA Eligibility status prior to assignment, a DRM message will be generated notifying you to do so at time of assignment.

  2. The employee enters an initial measurement period.

  3. At the end of the initial measurement period, the employee is evaluated for their full-time status.
    • If the employee is determined to be full-time, they have 30 days to enroll in (or decline) healthcare.
    • If the employee is found to be less than full-time, the employee enters the standard measurement period and will be re-evaluated at the end of that period.

  4. If at the end of the standard measurement period the employee is found to be of full-time status, the employee's ACA Eligibility is automatically changed from No to Yes, and the employee is placed in the administration period. When this period ends, the employee is placed in the standard measurement and determination rotation. This rotation continues as long as employee is employed.

  5. If the employee is determined to be less than full-time, the employee enters the standard measurement and determination rotation. This rotation continues as long as employee is employed.

 

 

 

ACA Process for Existing Employees

This section provides an overview for setting up ACA coverage for employees hired or placed on an initial assignment before January 1, 2015.

 

Full-Time Employee: 30 or more service hours per week

  1. The employee enters an administration period; this is a period of at least 30 days and can be up to 90 days. This period is set in Admin Tools and used for all employees.
    Note: If the ACA Eligibility is met, Avionté will change the setting to Yes at the end of the period.

  2. Before the Admin Period ends, enter the employee's insurance offer and corresponding enrollments or declinations into the ACA Companion. At this time, the employee leaves the Admin Period and enters the standard measurement period.
    Note: Coverage cannot be removed during this time.

  3. At the end of the standard measurement period, the employee is evaluated for full-time status.
    • If the employee meets full-time status, they continue the standard measurement and determination rotation.
    • If the employee evaluates at less than a full-time status, the employer can elect to drop coverage for that employee. The standard measurement and determination rotation continues to repeat as long as they are employed.
      Note: The system will not automatically change ACA Eligibility of Yes to No.

 

Variable Hour Employee: 29 or less service hours per week

  1. The employee has been working part-time. The ACA Eligibility status is initially set to No. The employee enters into a standard measurement period.

  2. At the end of the standard measurement period, the employee is evaluated for full-time status.
    • If the employee is determined to be full-time, averaging at least 30 service hours a week within the measurement period, they must be offered a healthcare plan and, if accepted, be enrolled prior to the end of the Admin Period. As a full-time employee they continue to repeat the standard measurement and determination rotation as long as they are employed.
    • If the employee is determined to be less than full-time, the employee's deductions and contributions related to ACA can be made inactive. The employee now begins a new standard measurement period. At the end of the standard measurement period, the employee is re-evaluated for their full-time status. This standard measurement and determination rotation continues as long as they are employed.

 


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