Affordable Care Act benefits
Learn more about ACA benefits for qualifying employees. This guide explains coverage under the Patient Protection and Affordable Care Act, eligibility and employment guidelines.
The Patient Protection and Affordable Care Act is a federal statute that was signed into law in March 2010. Along with the Health Care and Education Reconciliation Act of 2010, the law includes numerous health-related provisions to take effect over a four-year period, including expanding Medicaid eligibility, subsidizing insurance premiums, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage or claims based on preexisting conditions, establishing health insurance exchanges and support for medical research. The costs of these provisions are offset by a variety of taxes, fees and cost-saving measures, such as new Medicare taxes for high-income brackets, taxes on indoor tanning, improved fairness in the Medicare Advantage program relative to traditional Medicare, and fees on medical devices and pharmaceutical companies; there is also a tax penalty for citizens who do not obtain health insurance unless they are exempt due to low income or other reasons. The Congressional Budget Office estimates that the net effect, including the Reconciliation Act, will be a reduction in the federal deficit by $143 billion over the first decade.
1095-C communication notices
As required by the IRS, you will receive an IRS Form 1095-C containing important information about your prior year’s health care coverage. IRS Form 1095-C is not filed with your tax return. The IRS uses the information to confirm you had health care coverage in the previous year as mandated by the Patient Protection and Affordable Care Act. It is important to retain the form with your tax records.
You will receive the form if one of the following applies:
- You were considered benefits-eligible in the previous calendar year.
- You worked an average of 30 or more hours per week during the previous measurement period.
If you believe you should have received a 1095-C from ASU and have not received it, contact HR Employee Services. Visit the Healthcare Marketplace or contact your tax preparer for tax-related information.
Form W-2 notice
Pursuant to the Affordable Care Act for tax years starting on and after Jan. 1, 2011, in addition to the annual wage and tax statement, employers must report the value of each employee’s health coverage on the W-2 form, although the amount of health coverage will remain tax-free.
Notice of rescission
Under the Affordable Care Act, an individual’s coverage cannot retroactively be canceled or terminated, except in cases of fraud and similar situations. In the event that the plan rescinds coverage under the allowed grounds, affected individuals must be provided at least 30 days advanced notice.
Premium costs
Under the ACA, ASU is required to make health care premiums affordable. You will be responsible only for your share of the benefit premium costs. Your share will be automatically withheld from your biweekly paychecks.
Additional resources
Employment definitions.
Health insurance marketplace notice.
MetLife plan document from ADOA.
Summer faculty positions chart.