PPACA regulations require that certain breaks or leaves be included/excluded from the calculation of average hours to determine medical coverage eligibility, as follows:
- Periods of FMLA and Military Leave are excluded from the calculation.
- Summer breaks in which there are no hours worked in a four-week period (June, July, August) are excluded. If there are any hours worked during a summer month (June, July, August) then that month will be included in the calculation.
- Regulatory guidance has only allowed for the exclusion of summer breaks and has not outlined exclusion of holiday breaks (i.e. Winter break, Spring break, Thanksgiving break). Therefore, holiday breaks will be included in the calculation.
- Otherwise, unless the employee is terminated, any worked time over the 12-month measurement period will be included. Periods of time not worked will lower the overall average and lessen the employee’s probability of qualifying for coverage under PPACA.