Q: Are Part-Time Employees Eligible for Health Insurance?

Yes, part-time employees are eligible for health insurance, if the employer chooses to offer it to them. However, federal law does not require employers to offer health insurance to part-time employees.   

Let’s back it up for a moment: just how many hours a week is part-time? When it comes to health care, you have to follow the Affordable Care Act’s (ACA’s) definition:

Part-time employees work on average less than 30 hours per week, or less than 130 hours per month for more than 120 days in a row.

Offering health insurance to part-time employees is totally up to you as the employer. Just note that if you do choose to offer health insurance to part-time workers, you must follow the rules set by the ACA. 

What are the rules on offering health insurance to part-time employees?

Here are four steps that ensure you’re able to offer health insurance to part-time employees and remain compliant with ACA requirements.

1. Check with your insurance carrier

Make sure your insurance carrier allows you to offer health insurance to part-timers. Insurance companies have different rules around this. 

If you’re still shopping around for a health insurance plan for your employees, let your insurance broker know that you’re interested in the ability to offer coverage to your part-timers.

2. Be consistent in how and whom you offer coverage to

According to the ACA, if you offer health insurance to full-time employees, then you have to offer health insurance to all similarly situated full-time employees.

In the same way, if you offer health insurance to part-time employees, you have to offer health insurance to all similarly situated part-time employees. You should clearly articulate and record in your company policy documents the specific factors that make a part-time employee eligible for health coverage … which brings us to the next step.

3. Set your own requirements for part-time eligibility

If you decide to offer health benefits to part-time employees, you can write your own requirements for how those part-timers can qualify for it. It’s a good idea to include this information in your employee handbook

For example, you could set a policy that enables employees to qualify for health insurance if they:

  • Work at least 10 hours a week,
  • Work at least 40 hours per month, or
  • Work for you at all, meaning anyone who is employed by you can get health insurance.

4. Make sure you meet your minimum participation requirements.

Most health insurance carriers and states require that a minimum percentage of your workforce that is eligible for health insurance actually takes you up on it and uses it. Offering health insurance to part-time employees can affect that minimum participation percentage.

Gusto makes payroll, benefits, and HR actually easy.

What about QSEHRA—can I offer it to part-time employees?

Let’s take a step back, if you don’t know what QSEHRA is, here’s a short explanation: QSEHRA (an acronym for Qualified Small Employer Health Reimbursement Arrangement) is a health benefit that enables employers—who don’t offer health insurance—to help their employees with health coverage. With QSEHRA, an employer can reimburse employees for certain medical expenses (up to a predetermined amount). 

If your company has fifty or fewer employees and has opted to offer a QSEHRA instead of traditional group health insurance, you can include part-timers in that arrangement as well. As always, just be sure to be consistent and offer it to all eligible part-time employees equally.

Figuring out health insurance, or healthcare arrangements (in the case of QSEHRA) for your employees can get complicated, so it’s best to work with a broker who can keep your business compliant and select a health insurance plan that’s right for your company and team.

Remember: part-time employees may qualify for other health-related benefits

While providing health insurance for part-timers is optional, providing paid sick days may be required. There are no federal laws that mandate paid sick leave for part-time employees, but many states do require that this benefit be provided by employers. 

Your part-time employees may also qualify for the Family and Medical Leave Act—which provides up to 12 weeks of job-protected leave—if your company has 50 or more employees and they’ve worked for your company for at least one year and 1,250 hours. This can occur when, for instance, a full time employee moves to a part-time role.

Make sure you understand how to stay compliant with both federal and state laws.

Originally published on Nov. 1, 2019.

Comments

  • Michelle Mayer

    I am a part time employee and would like to get insurance through my employer. They pay a percentage of full time employee. Can I just pay the whole premium since I’m part time?

    Reply
    • Gusto Editors

      Hi Michelle — try checking with your attorney, as they’ll be able to give you legal advice specific to your situation!

      Reply
  • Pete

    The supervisors in my township in Pa just voted to give health care to new supervisors in the future. They do not work full time. Since they did this by PA law, are part-time employees also entitled to health insurance?

    Reply
    • Gusto Editors

      Hi Pete! Given that regulations change over time and can vary by location and employer size, we recommend that you consult a licensed broker for specific guidance!

      Reply
  • Victor

    Hi. You say that “When it comes to health care, you have to follow the Affordable Care Act’s (ACA) definition where part-time employees are those who work less than 30 hours per week.” and “Just note that if you do choose to offer health insurance to them, you have to follow the rules set by the ACA.” But then step 3 says that the employer can set it’s own rules: “If you decide to open up health benefits to part-time employees, you can write your own requirements for how those part-timers can qualify for it.” Could you clarify?

    Reply
    • Gusto Editors

      Employers are not legally required to offer health insurance to part-time employees. Under the ACA, an employee is part-time if they work less than 30 hours per week or 130 hours per month. Check out our blog post for more information on the distinctions between full- and part-time employees.

      The ACA requires that you offer consistent benefits to similarly situated employees. If you decide to offer health insurance to part-time employees, make sure to establish a clear written policy regarding what makes a part-time employee eligible.

      Reply

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