If you’re an employer with 50 or more full-time equivalent employees, you generally must offer full-time employees and their dependents the opportunity to enroll in your health plan if they’re otherwise eligible for it. A full-time equivalent measurement generally refers to the total hours that a full-time employee is expected to work in a calendar month, which includes both the hours actually worked and those for which the employee used earned paid time off.
Generally, part-time employees are not eligible for medical insurance benefits. However, there may be exceptions. In addition to the Fair Labor Standards Act (FLSA), there is a provision under the Affordable Care Act that requires employers to provide health insurance to employees working more than 30 hours per week. While not the norm, there are some employers that are willing to provide health insurance coverage to their part-time employees if they meet specific criteria. Some companies may make this offer on a case-by-case basis if they feel the employee will add value or perform their job at a higher level if they are receiving medical insurance.
The answer to this question depends on the employer. Some employers offer health insurance for their employees after they have worked a certain number of hours, while other employers offer it after a certain period of time has passed.
Generally, however, an employee will be eligible for health insurance if they work at least 30 hours per week or 40 hours per week depending on what kind of job they have and what state they live in.
How Many Hours Do You Need To Work Per Week To Get Health Insurance?
Knowing that you have access to high-quality, affordable healthcare is a major concern for workers all around the world. Unfortunately, access to health insurance is sometimes limited by the number of hours you work in a week.
Many part-time employees are excluded from employer-sponsored healthcare by the Affordable Care Act in the United States and similar legislation is other countries. In light of this, it’s no surprise that many employees worry that a switch to a 4-day work week will impact their ability to access the health insurance they rely on.
Hours and Healthcare Access
The first thing to note is that, in general, the number of hours you work per week does not directly impact your ability to get health insurance. In most countries, either your employer or the government is responsible for offering you health insurance, and they are required to do so regardless of how many hours you work.
One notable exception to this rule is…
The United States
In the United States, the Affordable Care Act (ACA) requires employers to offer health insurance only to employees who work 30 or more hours per week. Luckily, this limit is less than the 32 hours that 4-day week employees typically get to work per week.
This means that if you work fewer than 30 hours per week in the USA, your employer is not required to offer you health insurance under the ACA. However, this does not mean that you will not be able to get health insurance—it simply means that you will have to obtain it in another way.
The good news is that there are a number of other ways to get health insurance if you work fewer than 30 hours per week in the USA. For example, you may be eligible for:
- Medicaid: This government-sponsored health insurance program is available to low-income individuals and families. You can learn more about Medicaid here.
- COBRA: This program allows you to keep your employer-sponsored health insurance for a limited time after leaving your job. You can learn more about COBRA here.
- Individual Health Insurance: This is health insurance that you purchase yourself, rather than getting it through an employer. You can learn more about individual health insurance here.
- Medicare: This is a government-sponsored health insurance program for seniors and people with certain disabilities. You can learn more about Medicare here.
If you work fewer than 30 hours per week in the USA and your employer does not offer health insurance, you have a few different options for obtaining coverage. Medicaid, COBRA, individual health insurance, and Medicare are all viable options that you can explore.
Exceptions in the United States
A US company isn’t required to offer health insurance to workers who work less than 30 hours per week, but some companies still choose to do so. Some examples include:
- Avela
- Aetna
- Activision Blizzard
Additionally, some states have their own laws that require employers to offer health insurance to workers who work fewer than 30 hours per week. For example, in New Jersey, any business with 2-50 employees that offers a health insurance plan must offer that plan to all employees who work more than 25 hours per week.
Internationally
Like we mentioned earlier, getting access to employee health insurance is much easier in many other countries around the world thanks to government sponsored, universal healthcare. In these countries, your ability to get health insurance is not dependent on how many hours you work per week.
Some examples of countries with universal healthcare include:
- The European Union
- United Kingdom
- China
- Canada
- Russia
- Australia
- New Zealand
- India
- South Africa
- Bahrain
- Brunei
- Cyprus
- Hong Kong
- Iceland
- Israel
- Japan
- Kuwait
- Norway
- Singapore
- South Korea
- Switzerland
- United Arab Emirates
It’s important to note that, while the number of hours you work per week does not directly impact your ability to get health insurance in most countries, it can still indirectly impact your ability to get coverage.
For example, if you work fewer hours, you may be less likely to qualify for certain government-sponsored health insurance programs. Additionally, if you work fewer hours, you may also have a lower income, which can make it more difficult to afford private health insurance.
Summary
The number of hours you work per week does not have a direct impact on your ability to get health insurance in many countries around the world.
In the United States, you need to work at least 30 hours per week in order to qualify for employer-sponsored health insurance. However, there are a number of other ways to get health insurance if you work fewer than 30 hours per week in the USA, such as Medicaid, COBRA, individual health insurance, or Medicare.
How many hours is full time in california for health insurance
Health Benefits
State health benefits are administered through the California Public Employees’ Retirement System (CalPERS). Employees are eligible for health benefits if they have a permanent appointment or a limited-term appointment of more than six months (at least six months plus one day); and a time base of half-time or more.
Permanent-intermittent employees are eligible for health benefits after being credited with a minimum of 480 paid hours at the end of a six-month control period.
The State pays a portion of your premium, referred to as the employer contribution. The amount you receive is negotiated through the collective bargaining process for (union) represented employees, and determined by the California Department of Human Resources (CalHR) for excluded employees.
You have 60 calendar days from the date of your qualifying appointment to enroll in a health plan. Your coverage becomes effective the first day of the month following the date that your personnel office or health benefits officer receives your completed enrollment form.
The cost to you will be the difference between the monthly premium of the plan you choose and the employer contribution. Your share of the premium is paid through pre-tax payroll deductions. You may enroll in any of the health plans offered by the state where you live or work.
If you have qualifying group health coverage through another source, such as your spouse, you may choose to receive cash in lieu of the State’s health benefit. This additional cash is treated as taxable income.
If you have qualifying group health coverage through another source, such as your spouse, you may choose to receive cash in lieu of the state’s health benefit. This additional cash is treated as taxable income. You may enroll in the CoBen Cash Option when you are hired, during the annual open enrollment period, or when you gain other qualifying group health coverage.
Refer to FlexElect Medical and Dependent Care Reimbursement Accounts for details on using non-taxable payroll deductions to pay for certain medical expenses that are not covered by your state health benefits.
Dental Benefits
Employees who have a permanent or limited-term appointment lasting at least six months and a day and a time base of half time or more, are eligible for State-sponsored dental insurance from one of several plans.
Eligible employees can enroll within the first 60 days of employment eligibility, or during the annual open enrollment period. Voluntary changes in coverage are permitted during open enrollment or based on a permitting event outside of open enrollment.
If you are eligible for the State’s indemnity plan, Delta Dental, the State will pay 75% of the monthly premium. If you enroll in a State prepaid dental plan, the State will pay 100% of the monthly premium.
Most newly hired rank and file employees are only eligible for a prepaid dental plan during the first 24 months of State service.
If you have questions on Dental Benefits and your eligibility, contact your department’s Personnel Office.
Vision Benefits
Most State employees appointed to a permanent position that’s half time or more and their dependents are automatically enrolled in the State’s vision benefits.
The effective date of coverage is based on when your Personnel Office processes the Personnel Action Request (PAR) document, which is a transaction to record your appointment.
Please note that Permanent Intermittent Employees (PIE) must complete an enrollment form to enroll in vision benefits after working 480 hours in a specific control period.
If you have questions on Vision Benefits and your eligibility, contact your department’s Personnel Office.
Consolidated Benefits (CoBen)
Rather than receiving three separate State contributions for medical, dental, and vision benefits, employees eligible for Consolidated Benefits (CoBen) receive a single monthly contribution to pay for all three benefits.
If the CoBen allowance exceeds the total cost of the medical, dental, and vision plans an eligible employee has chosen, the employee receives the excess amount as additional taxable income each month.
If the CoBen allowance is less than the total cost of the benefit plans the employee has chosen, the employee pays the difference through pre-tax payroll deductions.
All excluded employees (classified as managerial, supervisory, confidential, exempt) are under CoBen. For rank-and-file employees, CoBen eligibility is determined through the collective bargaining process.
Ask your Personnel Office or check your bargaining unit contract if you are unsure of your eligibility for CoBen. Currently, employees in Bargaining Units 2, 7, 8, 16, 17, 18, and 19 are under CoBen.
Cash Option
Employees with medical and dental insurance through another source, such as a spouse or domestic partner, may elect to receive cash in lieu of enrollment in a State medical and dental benefit.
This additional cash is treated as taxable income. Enrollment in the cash option is permissive at the time of hire, during the annual open enrollment period, or based on a family status change. Enrollment in the cash option for dental only is not allowed.
FlexElect Medical and Dependent Care Reimbursement Accounts
Employees who pay out-of-pocket medical and dependent care expenses during the year may benefit from a FlexElect Reimbursement Account.
Medical Reimbursement Account
Most State employees are eligible. With a FlexElect Medical Reimbursement Account, you can use payroll deductions to pay for medical expenses that are not covered by your health, dental, or vision plan.
Dependent Care Reimbursement Account
A FlexElect Dependent Care Reimbursement Account lets you use payroll deductions to pay for day care expenses for an eligible child or parent. When you enroll in a reimbursement account, you specify an amount to be deducted from your paychecks each month for a plan year. These monthly deductions are not counted as taxable income.
Your funds are held in the FlexElect Program Fund, which you use to reimburse yourself for covered expenses that you and eligible dependents incur during the plan year. In order to be reimbursed funds from your reimbursement account, you must submit a reimbursement account claim form by a specified deadline.
Cash Option
Employees with medical and dental insurance through another source, such as a spouse or domestic partner, may elect to receive cash in lieu of enrollment in a State medical and dental benefit. This additional cash is treated as taxable income.
Enrollment in the cash option is permissive at the time of hire, during the annual open enrollment period, or based on a family status change.
Medical Provider Network – Physician and Medical Facility Designation
In the event of an industrial injury or illness, State of California employees will receive treatment through the Medical Provider Network (MPN).
As an alternative, you may designate your regular primary care physician to treat you in the event of an industrial injury or illness by notifying your employer in writing before an injury or illness occurs. The physician you designate must meet specific criteria and agree ahead of time to treat you in the event of an industrial injury or illness.
If you have questions on the Medical Provider Network and Physician and Medical Facility Designation, contact your department’s Personnel Office.
Beneficiary Designation – Death Benefits
Active and retired California Public Employees’ Retirement System (CalPERS) members have death benefit coverage. Upon the death of a covered employee or retiree, their beneficiary may be eligible for a monthly allowance and/or a lump-sum payment of benefits.
It is recommended that employees and retirees have a current Beneficiary Designation form on file with CalPERS.
120-Day Death Benefits
Under the 120-day death benefit, departments are required to continue to pay the employer contributions for a covered employee’s spouse, domestic partner and/or other eligible family members for up to 120 days following an employee’s death.
The 120-day period is to provide the family a grace period while the CalPERS determines if the spouse or other family members are eligible for a survivor’s benefit.
Military Service Declaration
Based on military service, you may qualify for certain benefits during your State of California career under the Military and Veterans Code. In order to determine if you qualify for benefits, please complete the Military Service Declaration form and give it to your department’s Personnel Office.
Military Service Declaration Form
Documents That May Be Requested By Your Department
There are certain documents to be completed by newly-hired employees, such as:
- Employment Eligibility Verification Form I-9 (required by Federal Law)
- Race/Ethnicity Questionnaire (voluntary)
Obtain the following documents from your department’s Personnel Office:
- Disability Questionnaire
- Electronic Communication and Software Policy User Consent Form (typically relates to computer use and communication)
- Emergency Contact Information Form
- Incompatible Activity Statement (forbidden activity)
- Nepotism Policy and Verification of Receipt
- Sexual Harassment Information Form
- Vehicle Safety Belt Use Certificate (if applicable)