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who is eligible for benefits?

A full-time employee is generally an employee who works on average 130 hours per month, as defined by the Affordable Care Act (ACA). ACA full-time status can affect or determine medical benefits eligibility but is not a guarantee of benefits eligibility. The PUD uses the look-back measurement method to determine whether an employee meets this eligibility threshold.


New Employees

If you are a new employee hired to work at least 30 hours a week/130 hour a month, you will be offered medical benefits on your date of hire.

If you are a bargaining-unit employee, benefit eligibility is determined in accordance with the collective bargaining agreement.

If, as of your date of hire, the PUD is unable to determine that you are a full-time employee, you will not be offered medical benefits immediately. Instead, you will be placed into an initial measurement period; a 12-month period to determine whether you are a full- time employee and eligible for benefits. Employees hired with the following schedules will be placed into an initial measurement period, including those hired into a:

Part-time position: A position where hours vary, and the PUD is unable to determine whether you will work on average 130 or more hours a month.

Seasonal position: A position where you are expected to work for six (6) months or less (regardless of monthly hours worked).

Your 12-month initial measurement period will begin on the first of the month following your date of hire and will last for 12 months. If, during your initial measurement period, you average 130 or more hours a month over that 12 month period, you will become full-time and, if otherwise eligible for benefits, you will be offered coverage by the first of the second month after your initial measurement period ends. Your full-time status will remain in effect during an associated stability period that will last 12 months. If your employment is terminated during that stability period, and you were enrolled in benefits, you will be offered coverage under COBRA.

 

Ongoing Employees

The PUD uses the look-back measurement method to determine medical plan eligibility for ongoing employees. An ongoing employee is an individual who has been employed for an entire standard measurement period. A standard measurement period is the 12-month period of time over which the PUD counts employee hours to determine which employees work full-time.

An employee is deemed full-time if he or she averages 130 or more hours a month over the 12-month standard measurement period. Those employees who average 130 or more hours a month over the 12-month standard measurement period will be full-time and, if otherwise eligible for benefits, offered coverage as of the first day of the stability period associated with the standard measurement period, which is the same as our plan year.

Full-time status will be in effect for the 12-month stability period. If your employment is terminated during a stability period, and you were enrolled in benefits, you will be offered coverage under COBRA.

The PUD uses the standard measurement period and associated stability period annual cycle outlined below.

Measurement Period: November 1 - October 31

Time to determine if you work 130+ hours per month on average – used to establish if you are “full-time” or “part-time” for medical eligibility.

Stability Period: January 1 - December 31

Time during which you will be considered “full-time” or “part-time” for medical plan eligibility, based on hours worked during preceding measurement period.