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Patient Protection and Affordable Care Act (PPACA)

The Patient Protection and Affordable Care Act (PPACA), or Health Care Reform law, is a United States federal statute signed into law in 2010. The University of Missouri System (UM) is meeting the requirements of this law. Navigate to the information you’re interested in by using these links:

This webpage does not cover all of the requirements of the law. You may wish to review the university’s PPACA FAQs for more information. Or consult for a full explanation of the law.

Employer impacts

The law requires that employers with 50 or more full-time employees—like the university—offer medical insurance to employees and their children up to age 26. Employers not offering medical insurance may have to pay a penalty to the government. The federal statute requires that UM:

  • Offer medical insurance coverage to certain variable-hour employees.
  • Establish and administer a measurement system and policies to determine which variable-hour employees are eligible.
  • Notify employees of their medical insurance choices, including the federal Health Insurance Marketplace coverage availability.

The university already offers medical insurance to benefit-eligible employees, but the PPACA requires the UM System to also offer medical insurance to variable-hour employees—specifically those variable-hour employees who work an average of 30 hours or more per week over a measurement period. A variable-hour employee is defined as one who works for the university but is not fully benefit eligible. In the past, the term “part‐time” has most commonly been used.

All newly-hired employees will receive the required "New Health Insurance Marketplace Coverage Options and Your Health Coverage" letter by mail. This letter will provide basic information about the Health Insurance Marketplace and health coverage offered by the University of Missouri System. 

Individual impacts

The PPACA requires that most Americans have medical insurance coverage, whether they get it from the university or another employer, a spouse’s or partner’s insurance, an insurance company, or the government. You can access information about the PPACA’s requirements for individuals and families at

If you are offered coverage, you may read about our insurance plans on the health programs webpage, and access tools to help you decide which plan is right for you.

Measurement periods

Under the PPACA’s requirements, variable-hour employees who work an average of 30 hours or more per week in all university jobs over a measurement period must be offered access to the UM System’s medical plans, although any employee may decline or waive the coverage. Measurement periods are determined by the university in compliance with PPACA regulations. These measurement periods apply only to variable-hour employees. Eligibility and enrollment information is provided on the medical insurance eligibility webpage.

There are two types of measurement periods:

New-hire measurement period

This is an 11-month measurement period that begins on the first day of the month after a newly hired, variable-hour employee begins work (unless hired on day one of a given month). For example, if your first day of work was June 16, 2023, your measurement period would run from July 1, 2023, to May 31, 2024.

The UM System measures an employee’s work hours after this period to determine if they averaged 30 hours or more per week. If yes, the university notifies the employee that they have become eligible for university medical insurance via a written statement sent to their home address on file. The notification explains that the employee will be offered insurance for 12 months after eligibility.

Ongoing measurement period

The UM System offers medical insurance to eligible variable-hour employees for 12 months at a time, in accordance with the PPACA. The university re-measures variable-hour employees each year to be sure that these employees should continue to receive insurance in subsequent years.

The university’s ongoing measurement period is the same for everyone, regardless of when each employee was first offered insurance. The period is October 3 of one year to October 2 of the next year (e.g., October 3, 2022, to October 2, 2023). The measurement period must total 52 weeks. Depending on how the dates above fall in the pay period, the beginning and end dates might shift.

No longer eligible

If an employee is enrolled in medical insurance and becomes ineligible for coverage, they will receive a written statement (delivered to the mailing address on file) indicating that they are eligible to be a COBRA participant for up to 18 months. ASI, the university's COBRA administrator, will then send an enrollment packet. More information on COBRA can be found on the COBRA webpage.


Request a review of eligibility by visiting the medical insurance eligibility webpage. All employees have the right to appeal their offer of coverage or appeal their eligibility of coverage by contacting the HR Service Center.

Reviewed 2024-02-28


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