1435 Morris Avenue - Suite 3A, Union, NJ 07083
Tim Haresign, President
Adjunct Faculty and the Affordable Care Act
Now that the Affordable Care Act (ACA) is in full effect, everyone is supposed to have coverage by March 31, 2014 or pay a penalty. We continue to receive calls from adjunct faculty members regarding their health insurance options. The choices can be confusing. One thing is certain: there is no single answer.
For many adjuncts health coverage is obtained through a full-time job other than teaching at a NJ State College/University, through their spouse’s plan, or, if retired through Medicare benefits. Nothing changes for these people under the ACA.
For those not covered in the ways described above, how and where they obtain coverage through the ACA depends upon an adjunct’s income level and where they reside.
Some years ago the Council successfully lobbied to make the State Health Benefits Plan available for purchase by adjunct faculty. This option, while expensive, provides good coverage and did so at a time when not much else was available. Under the ACA if the employee’s premium for self-only coverage in the employer’s least expensive plan exceeds 9.5% of the employee’s household income, then the coverage is considered “unaffordable” and the employee is eligible to receive subsidized coverage in the exchange provided the employee’s household income is at or below 400% of the federal poverty level. Individuals will have to do their own calculations. If you currently have and are satisfied with SHBP coverage you may keep it.
Federal Poverty Guidelines (400%) (source:http://www.familiesusa.org/resources/tools-for-advocates/guides/federal-poverty-guidelines.html )
ACA rules mention adjunct faculty, but do not resolve the question of how their status should be determined. The proposed rules do, however, require employers to use a “reasonable method” for crediting hours of service for adjuncts. Enforcement of the ACA is through the Internal Revenue Service (IRS). The interpretation of “reasonable” has been the subject of intense debate between organizations representing higher ed institutions and the organizations representing adjunct faculty. The IRS initially defined full-time employees as those working at least 30 hours per week. For Adjunct Faculty this has been recently revised (2/11/2014) to say the colleges will be considered on solid ground if they credit instructors for 1¼ hours of preparation time for each hours they spend in the classroom, and instructors should be credited for any time they spend in office hours or other required meeting time. In June 2013 the State of New Jersey Department of the Treasury, Division of Pensions and Benefits decided that State Colleges and Universities must credit adjunct faculty with eight hours for every day the employee comes to work. For example, an adjunct teaches one course per semester, for 50 minutes three days a week, is credited with 24 hours of work per week. Few if any adjuncts qualify for employer-subsidized coverage under this method. At this time (2/18/2014) the State of New Jersey Department of the Treasury, Division of Pensions and Benefits has yet to issue a revised formula.
How to apply for healthcare under the ACA:
Not all adjunct faculty members employed in the NJ State Colleges/Universities reside in New Jersey. New Jersey did expand its Medicaid coverage using Federal subsidies, but Governor Christie did not set up New Jersey’s own healthcare exchange. Accordingly you must visit the Federal Government site: www.healthcare.gov
If you live in New Jersey or Pennsylvania, you must enter the state you live in.
If you live in New York, where they set up their own exchange go to:
www.healthcarereform.ny.gov/health_insurance_exchange
In Delaware: http://www.delawareinsurance.gov/health-reform/ACA
Plans fall into 5 categories
These 5 categories (catastrophic, bronze, silver, gold, and platinum) are based on how you and the plan expect to share the costs for health care. The category you choose affects how much your premium costs each month and what portion of the bill you pay for things like hospital visits or prescription drugs. It also affects your total out-of-pocket costs - the total amount you'll spend for the year if you need lots of care.
Categories describe how much of the total average cost of care they cover.
Have your tax information (2013tax return, etc.) ID numbers (Social Security numbers for you and family members, birthdates, etc.) handy to fill in the forms on these sites. Your monthly premium depends on your income level, the coverage you choose and plan for which you qualify. If you qualify for Medicaid you will have no premium to pay.
All of these websites have toll-free numbers and call-in assistance for those who have trouble navigating the websites.
There have been 40 attempts - including a Federal government shutdown – to repeal the Affordable Care Act. The United States Supreme Court has ruled the ACA constitutional. The ACA is the law of the land with millions more Americans covered every day. The “roll-outs” of the Federal Income tax withholding in the 1940s, the introduction of Medicare in the 1960s, Medicare prescription benefits in the 2000s were just as full of glitches, confusion and headaches as the roll-out of the ACA. Nevertheless, these programs changed American life for the better. Likewise the ACA is here to stay and will continue to expand medical care in America.
Take advantage of it.