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About the ACA

Updates and Announcements about the ACA

At this time it is unknown if there will be any changes to employer requirements under ACA and what Stanford offers. However, for those who are eligible to enroll in a Stanford health plan, the Stanford plan will continue to be available with the rates and coverage provisions communicated during Stanford’s Open Enrollment.

We will communicate about any changes to ACA that would impact employees' coverage or eligibility through Stanford, and the timing of any changes once they are known. For those who buy their own insurance through an ACA Marketplace exchange like Covered California, they can still pick their plans during the Marketplace Open Enrollment period.


What is the ACA?

In 2010, the federal government enacted the Affordable Care Act (ACA), a comprehensive health care reform law that phases in a series of actions to occur over an eight-year period. The ACA is intended to:

  • Provide all Americans access to health care
  • Lower the cost of quality health care
  • Protect health care consumer rights

To expand health care coverage, as part of the Employer Shared Responsibility Provision, also known as the employer mandate, all employers with 50 or more full-time equivalent employees (FTE) are required to provide minimum essential medical coverage (MEC) to at least 95 percent of their full-time employees and dependents up to age 26.

Full-time employees for ACA purposes are those who work, or are expected at hire to work, an average of 30 hours or more per week. At Stanford, these include not only Stanford’s benefits-eligible employees, but also Stanford’s temporary, casual, and student employees.

Employers are also required to report coverage information to the IRS and furnish covered individuals with a form that shows compliance with the individual shared responsibility provision of ACA. The annual notification, also known as the IRS Form 1095-C, must be sent annually to full-time employees and individuals covered by a self-insured plan by the end of January. In addition, fully-insured health plan insurers, like Kaiser, must send a similar IRS Form (1095-B) to covered individuals.


What Action does Stanford Take and Who is Affected?

To comply with the ACA Employer Shared Responsibility mandate, Stanford takes several actions that impact all Stanford employees and ACA-eligible employees. Below is a summary of actions Stanford takes:

ACA-Eligible Enrollment
(for full-time temporary, casual and student EMPLOYEES)
IRS Form 1095-C
(Stanford employees, retirees and other covered Individuals)

October:

Stanford notifies ACA-eligible employees that qualify for medical coverage of the health Open Enrollment period. ACA-eligible employees are identified based on a “look back” of service hours from October of the prior year to October of the current year.

December:

Stanford will inform benefits-eligible employees of how to elect IRS Form 1095-C delivery preference (electronic or USPS Mail).

Mid-October to Mid-November:

Open Enrollment period to elect medical coverage.

January:

Stanford will provide full-time employees and individuals covered by self-insured plans an IRS  Form 1095-C by the end of the month.

Fully insured plans, such as Kaiser, will send  their covered employees and individuals an IRS Form 1095-B.

January:

Medical coverage elected at Open Enrollment is effective January 1st.
 

During the year:

New Hire and Rehire ACA-eligible employees are notified when they qualify for medical coverage.