Who is considered ACA-Eligible at Stanford?
The ACA employer mandate covers all Stanford employees who work full time by ACA standards. 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. They include not only Stanford’s benefits-eligible employees, but also Stanford’s temporary, casual, and student employees. Stanford’s temporary, casual and student employees who meet the ACA’s full time standard are referred to at Stanford as “ACA-eligible” employees.
ACA-Eligible Employee Coverage
To comply with the ACA employer mandate, starting January 1, 2016, all full-time temporary, casual and student employees identified as ACA-eligible will be offered the ACA Plan. The ACA Plan is a high deductible health plan that provides affordable minimum essential medical coverage (MEC) to full-time temporary and casual employees and their eligible dependent children up to age 26.
Below are high level details on the ACA Plan:
| ACA Plan Coverage (administered by Blue Shield) | In Network | Out of Network |
|---|---|---|
|
Deductibles |
$3,250 individual |
$6,500 individual |
|
Costs Covered |
60% of costs covered after you’ve paid the deductible |
50% covered after you’ve paid the deductible; deductible is also higher for out of network services. |
|
Out-of-Pocket Maximums |
$6,750 individual |
$13,000 individual |
|
Health Savings Account (HSA) |
With this plan, you may open an optional Health Savings Account (HSA) by contacting a financial institution of your choice. The HSA helps you pay for eligible health care expenses by setting aside tax-deductible funds. |
|
View the 2016 ACA Plan Summary of Benefits & Coverage
ACA Plan Rates
| Medical Plan Costs | Semi-Monthly Total Cost | Semi-Monthly University Contribution | Your Semi-Monthly Contribution |
|---|---|---|---|
| Employee Only | $270.66 | $225.89 | $44.77 |
| Employee & Child(ren) | $487.20 | $218.40 | $268.80 |
ACA-Eligible Enrollment: December 2-16, 2015
If you qualify for ACA-eligible coverage, you will be notified in November about the opportunity to elect Stanford medical coverage. A special ACA-Eligible Enrollment will be held from December 2-16, 2015. During this time, you may elect the ACA Plan coverage.
Please note, as part of the ACA’s individual shared responsibility, all individuals must have qualifying health insurance coverage for the year, either through employer coverage or through the Health Insurance Marketplace, such as Covered California, the private health exchange for California residents. Before enrolling in the Stanford ACA Plan, you may want to compare the ACA Plan coverage and costs with the medical plan options offered through Covered California.
Whether you elect Stanford coverage or not, if you are determined to be eligible for medical coverage, Stanford will provide you the IRS Form 1095-C each January, which notifies you of the coverage made available to you by Stanford in the prior year.
How to Enroll
ACA-eligible employees will receive an email notification when the ACA-Eligible Enrollment period begins. Medical plan elections can be made online through the My Benefits portal from December 2 through December 16.
