Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act (ACA) put in place comprehensive health insurance reforms designed to expand coverage, control health care costs, and improve the health care delivery system. The ACA includes requirements for employers and individuals.

Employer Mandate

Under the ACA, Ohio State is required to offer health insurance to certain employees. Many employees are eligible for coverage based on their employment classification and full-time equivalency. Those who are not eligible under the university’s eligibility rules – but who worked an average of 30 or more hours a week during the applicable measurement period – are considered an “ACA-eligible employee.”

These employees receive a notice of eligibility from the Office of Human Resources and may elect coverage under the Faculty and Staff Health Plans. The coverage is for medical and prescription only; it does not include dental or vision benefits.

Individual Mandate

In previous years, the ACA required all individuals, with a few exceptions, to have health insurance that provides “minimum essential coverage” or potentially pay a penalty for noncompliance. Through December 2018, individuals who could afford health insurance but chose not to buy it were able to pay a fee called the Individual Shared Responsibility Payment when filing federal taxes.

Starting with the 2019 plan year, individuals who don’t have coverage no longer need to pay the Shared Responsibility Payment.

Note: Some states have their own individual health insurance mandate, requiring individuals to have qualifying health coverage or pay a fee with state taxes. If you live in a state that requires you to have health coverage and you don’t have coverage (or an exemption):

  • You may be charged a fee when you file your state taxes.
  • You will not owe a fee on your federal tax return.

Check with your state or your tax preparer to find out if there is a fee for not having health coverage. For more information about the individual mandate, visit the website.

The Ohio State University Faculty and Staff Health Plans provide minimum essential coverage. An individual who was covered for at least one day during a month is considered to have had coverage for the entire month.