Can we create different benefit classes under the ACA (e.g., full-time vs. part-time, location, seasonal)?

Yes. Employers can create different benefit classes under the Affordable Care Act (ACA) as long as those distinctions are based on legitimate employment categories and applied consistently. The goal is to balance cost, compliance, and employee needs while ensuring fairness and avoiding discrimination.

Define bona fide employment classes
The ACA, along with ERISA and IRS guidance, allows employers to vary benefits by legitimate employment categories such as:

• Full-time versus part-time
• Hourly versus salaried
• Seasonal or temporary workers
• Union versus non-union
• Geographic location or worksite
• Different entities within a controlled group

Best practice: Classes must be based on clear, objective business reasons and never on protected characteristics such as age, gender, or health status.

Apply classes consistently
Once classes are defined, apply eligibility and benefit rules uniformly within each group. For example:

• All full-time employees should have the same plan options and contribution rates.
• All part-time employees should have the same cost and eligibility structure.
• Remote employees in the same state should receive consistent benefits.

Why it matters: Consistency prevents compliance risks under ERISA, ACA, and IRS nondiscrimination rules.

Know how the ACA defines full-time employees
Under the ACA, a full-time employee is anyone averaging 30 or more hours per week, or 130 hours per month. Large employers (those with 50 or more full-time employees) must:

• Offer Minimum Essential Coverage (MEC) to at least 95 percent of full-time employees and their dependents.
• Ensure that the coverage is affordable and provides Minimum Value (MV).

Key point: You can offer different plan levels or contributions to part-time or seasonal employees, but all full-time employees must receive ACA-compliant coverage.

Use ICHRAs for added flexibility
Individual Coverage Health Reimbursement Arrangements (ICHRAs) allow employers to vary contributions and plan structures by class, such as:

• Full-time versus part-time
• Seasonal employees
• Salaried versus hourly
• Geographic region or remote versus on-site

The IRS requires minimum class sizes (typically at least 10 employees or a percentage of your workforce) to prevent discrimination.

Best practice: Define classes clearly, document contribution logic, and ensure compliance with class size and consistency requirements.

Follow nondiscrimination rules

• Self-funded plans: Must comply with IRS Section 105(h), which prohibits favoring highly compensated employees in either eligibility or benefits.
• Fully insured plans: Are subject to ACA nondiscrimination provisions, though enforcement is currently delayed.
  
  

Example: It is acceptable to offer broader coverage to salaried employees than hourly workers, but not if it unfairly benefits executives.

Communicate clearly with employees
Employees should understand which class they belong to and what benefits are available to them. Provide this information clearly in your plan documents and during open enrollment.

Tip: Use plain, straightforward language instead of complex insurance terminology when describing coverage tiers.

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Vitable makes it easy to design benefits that meet the needs of every employee class. Whether your workforce is full-time, part-time, seasonal, or remote, every member receives $0 access to primary care, mental health, and prescriptions through virtual or in-home visits. Employers can pair Vitable with MEC, HDHP, or ICHRA plans to maintain compliance while ensuring equitable access to care across all groups.

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You can create different benefit classes under the ACA as long as distinctions are based on legitimate, documented employment categories and applied consistently. This flexibility allows you to tailor benefits by role, hours, or location while keeping full-time coverage ACA-compliant. With Vitable’s primary-care-first model, you can deliver affordable, equitable healthcare for every employee class while maintaining compliance and cost control.

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