NYC Substitute Teachers - No Benefits? (New York, York: 2015, rent, health insurance)
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This question is not for me, but for one of my staff members. I am now a manager of an after-school program for a large city agency, and have several staff members working under me. It's a low-paid part-time job, so many of them either look for 2nd jobs, leave altogether for full-time employment, or get promoted to full-time like I did.
Anyway, one of my staff members asked me to be a reference for a staffing agency that provides substitute teachers to schools in NYC, which I did. I also started helping her research the process to become a substitute teacher by reaching out directly to principals so that she can make more money and not have a fee taken out by the agency.
I found this directly on the DOE website, "Substitute Teachers, providing day-to-day service, are paid at the per diem contractual rate of $162.86 (as of May 2015), for the actual days worked; they do not receive any benefits."
My question is, does the DOE now limit how many hours a week substitutes can work to not provide benefits? Because I would think if they worked more than 29 hours, not providing benefits would be in violation of the ACA. Years ago (2007-2009), when I worked as a substitute, I had a full-time schedule and worked every day, but this was pre-ACA. Is this not done anymore? Or does the DOE have their own special rule where they don't have to give substitutes benefits, even if they work full-time because they say so?
My staff member is very concerned about this, and is worried she'll be kicked off Medicaid for making too much money, but she won't get any benefits from the staffing agency or the DOE. And the price of any decent ACA plan is too much money as well. She wouldn't be able to afford that, and pay rent/student loans. She's just a recent college graduate who can't find full-time work. She told me she might actually just wind up staying working where I am, and tutoring on the side for some extra cash because of the health insurance issue. And I don't blame her one bit!
Last edited by RandomPersonInNY; 03-28-2016 at 09:53 PM..
I found this directly on the DOE website, "Substitute Teachers, providing day-to-day service, are paid at the per diem contractual rate of $162.86 (as of May 2015), for the actual days worked; they do not receive any benefits."
My question is, does the DOE now limit how many hours a week substitutes can work to not provide benefits? Because I would think if they worked more than 29 hours, not providing benefits would be in violation of the ACA. Years ago (2007-2009), when I worked as a substitute, I had a full-time schedule and worked every day. Is this not done anymore? Or does the DOE have their own special rule where they don't have to give substitutes benefits, even if they work full-time because they say so?
My staff member is very concerned about this, and is worried she'll be kicked off Medicaid for making too much money, but she won't get any benefits from the staffing agency or the DOE. And the price of any decent ACA plan is too much money as well. She wouldn't be able to afford that, and pay rent/student loans. She's just a recent college graduate who can't find full-time work. She told me she might actually just wind up staying working where I am, and tutoring on the side for some extra cash because of the health insurance issue. And I don't blame her one bit!
The DOE is clearly stating that substitute teachers are free lancers, and as such are not entitled to benefits.
To go to your real question, however, your young friend should NOT let "What other people said" rule such a key decision! There are lots of low-cost health insurance options (see list below). It's great that she wants to pay off her student loans -- she absolutely should! ANDDDDD, NYC is a lot more fun with more money to spend. This is New York, we reward people who are willing to work hard -- can't find a full time job? Take three part-time ones!
IF her income rises above the Medicaid level and she is notified that she will be losing Medicaid, she will qualify for a Special Enrollment Period of 60 days. That means that the New York State of Health will open for her for 60 days, so that she can pick out health coverage. How can she afford that? Lots of options, keep reading! But she must not wait, as the clock will be ticking and at the end of the Special Enrollment Period, the window closes, whether she picked out a policy or not.
1. In 2016, NYS enacted a new feature of the ACA. It is free or extremely cheap health insurance for people whose income is just above the Medicaid level. If she's a citizen or legally in the US, she can qualify for either Essential Plan 1 or Essential Plan 2.
Am assuming she's a single person -- all incomes quoted here are for single people (those with children or who are married can have higher incomes).
2. Highest income you can have and still qualify for Medicaid (for an able-bodied person who can see, who is not on disability and does not have Medicare): $16,394/year (under 138% of the Federal Poverty Limit.
Here's a link for more about Medicaid eligibility -- scroll about half way down the page to the purple table for 2016 eligibility figures: Medicaid
3. What if her income creeps up over that? Earn between $16,395 - $17,820/year, she'll qualify for The Essential Plan 2. It's a regular health insurance plan, offered by about 10 different companies (Blue Cross, United Health Care, Emblem Health, etc.) but NYS subsidizes the premium ENTIRELY, so it costs $0/month (yep, it's free). Deductible: $0, very low copayments. Even better, don't have to wait for Open Enrollment to sign up -- anyone can sign up all year round.
4. What if her income is higher than that? Earn between $17,821 - $23,760, she'll qualify for The Essential Plan 1. Regular health insurance plan, offered by about ten different companies (Blue Cross, Emblem Health, United Health Care, etc.) Premium: $20/month. Again, can sign up any time of the year, don't have to wait for Open Enrollment.
5. Income higher than that? Earn between $23,760 - $29,700, she'll qualify both for premium subsidies to cover most of the cost of her monthly premiums AND if she enrolls in a Silver Level Plan, the Feds will also subsidize her deductibles and copayments on a sliding scale basis -- the closer she gets to $29,700, the smaller the help the feds give to lower her deductible. Wait, there's more -- the older you get, the less the insurance companies want you (more chance that something on you would break). They REALLY want people as young as your friend, so they skew the insurance premiums in her favor. If she were 60 she'd pay more for the same policy. But she just graduated, so she's not even 30 yet.
6, Income between $29,701 -$47,520, she'll still qualify for premium subsidies to help with the cost of her monthly premiums. As her income rises, the amount of the subsidy falls, but because she's still just 23, 24, the insurance companies all want her, because the chances are excellent she won't go to the doctor at all. So she'll STILL pay less for the same policy than a 60 year old.
7. Finally, in certain circumstances she can stay on her parent's employer-provided plan through age 29 (NOT a TYPO, "TWENTY-NINE"). This is because New York State has our own state law allowing parents to keep their adult children on their coverage up to age 29: Coverage Expansion Through Age 29 - “Young Adult Option" - FAQs
She should go browse around in the NY State of Health (the NY Health insurance marketplace) and compare some prices. She can browse at this link without having to set up a whole account in the NY State of Health. Scroll down to the "View Plans Now" button: https://nystateofhealth.ny.gov/individual
If she'd like to talk to someone and get some more information about anything here, New York State has funded a lot of non-profit community based organizations to provide in-person assistance to talk about health insurance options and help someone pick out the best deal for their needs. Here's a link to a county-by-county listing of all these in-person assistance programs: http://info.nystateofhealth.ny.gov/s...0Directory.pdf
Last edited by Inquring81; 03-28-2016 at 10:31 PM..
The DOE is clearly stating that substitute teachers are free lancers, and as such are not entitled to benefits.
To go to your real question, however, your young friend should NOT let "What other people said" rule such a key decision! There are lots of low-cost health insurance options (see list below). It's great that she wants to pay off her student loans -- she absolutely should! ANDDDDD, NYC is a lot more fun with more money to spend. This is New York, we reward people who are willing to work hard -- can't find a full time job? Take three part-time ones!
IF her income rises above the Medicaid level and she is notified that she will be losing Medicaid, she will qualify for a Special Enrollment Period of 60 days. That means that the New York State of Health will open for her for 60 days, so that she can pick out health coverage. How can she afford that? Lots of options, keep reading! But she must not wait, as the clock will be ticking and at the end of the Special Enrollment Period, the window closes, whether she picked out a policy or not.
1. In 2016, NYS enacted a new feature of the ACA. It is free or extremely cheap health insurance for people whose income is just above the Medicaid level. If she's a citizen or legally in the US, she can qualify for either Essential Plan 1 or Essential Plan 2.
Am assuming she's a single person -- all incomes quoted here are for single people (those with children or who are married can have higher incomes).
2. Highest income you can have and still qualify for Medicaid (for an able-bodied person who can see, who is not on disability and does not have Medicare): $16,394/year (under 138% of the Federal Poverty Limit.
Here's a link for more about Medicaid eligibility -- scroll about half way down the page to the purple table for 2016 eligibility figures: Medicaid
3. What if her income creeps up over that? Earn between $16,395 - $17,820/year, she'll qualify for The Essential Plan 2. It's a regular health insurance plan, offered by about 10 different companies (Blue Cross, United Health Care, Emblem Health, etc.) but NYS subsidizes the premium ENTIRELY, so it costs $0/month (yep, it's free). Deductible: $0, very low copayments. Even better, don't have to wait for Open Enrollment to sign up -- anyone can sign up all year round.
4. What if her income is higher than that? Earn between $17,821 - $23,760, she'll qualify for The Essential Plan 1. Regular health insurance plan, offered by about ten different companies (Blue Cross, Emblem Health, United Health Care, etc.) Premium: $20/month. Again, can sign up any time of the year, don't have to wait for Open Enrollment.
5. Income higher than that? Earn between $23,760 - $29,700, she'll qualify both for premium subsidies to cover most of the cost of her monthly premiums AND if she enrolls in a Silver Level Plan, the Feds will also subsidize her deductibles and copayments on a sliding scale basis -- the closer she gets to $29,700, the smaller the help the feds give to lower her deductible. Wait, there's more -- the older you get, the less the insurance companies want you (more chance that something on you would break). They REALLY want people as young as your friend, so they skew the insurance premiums in her favor. If she were 60 she'd pay more for the same policy. But she just graduated, so she's not even 30 yet.
6, Income between $29,701 -$47,520, she'll still qualify for premium subsidies to help with the cost of her monthly premiums. As her income rises, the amount of the subsidy falls, but because she's still just 23, 24, the insurance companies all want her, because the chances are excellent she won't go to the doctor at all. So she'll STILL pay less for the same policy than a 60 year old.
7. Finally, in certain circumstances she can stay on her parent's employer-provided plan through age 29 (NOT a TYPO, "TWENTY-NINE"). This is because New York State has our own state law allowing parents to keep their adult children on their coverage up to age 29: Coverage Expansion Through Age 29 - “Young Adult Option" - FAQs
She should go browse around in the NY State of Health (the NY Health insurance marketplace) and compare some prices. She can browse at this link without having to set up a whole account in the NY State of Health. Scroll down to the "View Plans Now" button: https://nystateofhealth.ny.gov/individual
If she'd like to talk to someone and get some more information about anything here, New York State has funded a lot of non-profit community based organizations to provide in-person assistance to talk about health insurance options and help someone pick out the best deal for their needs. Here's a link to a county-by-county listing of all these in-person assistance programs: http://info.nystateofhealth.ny.gov/s...0Directory.pdf
Thanks! This was very helpful information and I will pass this along to her. And also for myself, in the event that I lose my job and find myself in a similar position.
I went on NY State of Health for the fun of it and priced out some of these plans using some of the incomes you posted. Even with the subsidy, a decent plan still costs too much money. In order to get a plan with no deductible and very little out of pocket costs, you need a Gold plan or better. If you make $30,000 or more, you're pretty much screwed and would have to chose between paying rent or health insurance. One really is better off being lower-income on Medicaid, or on the Essential Plan. That's if you can't find a job with benefits of course; seems like it's easier to find a unicorn these days.
One thing that is still unclear to me is the part of your post I bolded. I thought in order to be classified as a free lancer, you filled out a different tax form and paid taxes at the end of the year? Because subs get a W-2, and don't exactly work for themselves. Taxes are also taken out of every paycheck. That is why I'm still confused as to how the city gets around giving benefits to subs if many of them are working 30-35 hours a week.
Thanks! This was very helpful information and I will pass this along to her. And also for myself, in the event that I lose my job and find myself in a similar position.
I went on NY State of Health for the fun of it and priced out some of these plans using some of the incomes you posted. Even with the subsidy, a decent plan still costs too much money. In order to get a plan with no deductible and very little out of pocket costs, you need a Gold plan or better. If you make $30,000 or more, you're pretty much screwed and would have to chose between paying rent or health insurance. One really is better off being lower-income on Medicaid, or on the Essential Plan. That's if you can't find a job with benefits of course; seems like it's easier to find a unicorn these days.
One thing that is still unclear to me is the part of your post I bolded. I thought in order to be classified as a free lancer, you filled out a different tax form and paid taxes at the end of the year? Because subs get a W-2, and don't exactly work for themselves. Taxes are also taken out of every paycheck. That is why I'm still confused as to how the city gets around giving benefits to subs if many of them are working 30-35 hours a week.
1. With regard to the issue of who is a freelancer, you make a good point. I don't know enough about employment law to be able to speak to this. Perhaps the key is in the words "at will employee," and that means something in employment law that we don't realize? Perhaps post this point in the forum on "Employment" or "Law" and see who responds?
2. With regard to the issue of "a decent plan costs too much money" -- I think you're constructing your comparison incorrectly. First of all, your younger friend, at 30, needs health insurance for a couple of things every year -- basic preventive healthcare (annual physical, GYN exam) and a handful of primary care visits. She can get these with out copays under the ACA, even if she picked a plan with a high deductible. It's also true that it's a wise idea to know what the income boundaries are, so that you can know and be planning for each step in income.
3. I totally think that most people get too focused on a "glass half full" mentality, and that many people stagnate when they say "Oh, if I took that job, I'd lose my coverage, or I'd lose Medicaid," and end the conversation at that point. The two of you are living in the greatest city on earth. If you're one in a million, there are eight people just like you here. That's a lot of people and a lot of opportunity. New Yorkers are famous for out of the box thinking -- find a need that no one is filling (or filling well) and make it work. I came here knowing no one, with a backpack, a dream and a BA. I've started three small businesses here, and helped found a lobbying organization. I didn't know anything about the business side of that kind of stuff -- I saw a need and got busy. Persistence is vital and you're only as limited as you allow yourself to be.
4. In terms of your evaluation of health care -- what's a decent plan -- and is that your framework for what YOU need or what SHE needs? What healthcare can she get economically outside of her health plan? For example, she's a young woman, might be sexually active in the city that is leading the HIV epidemic in this country, and might want to think about Pre-Exposure Prophylaxis (PrEP) taking one pill a day to dramatically lower her chances of getting HIV. Use PrEP and a condom, your chances of getting HIV if the condom breaks shrink to 7%. But rather than pay for it using health insurance, the State Department of Health will pay for the medical care connected with PrEP (four doctor visits a year and lab tests) for free for anyone who is single, lives in NY State (without regard to citizenship), has income under 435% of the Federal Poverty Level ($51,768 for single person, higher for marrieds and those with children) and has less than $25,000 in stocks and bonds. The manufacturer of the drug is giving away the medication nationwide to people with income under 500% of FPL (somewhere in the area of $58,000/year).
But in the meantime, if she allows herself to have an income higher than Medicaid ($16,394) she might well come across employment opportunities that could lead to jobs with benefits. Stay married to Medicaid, and ten years from now, she'll be much more stuck.
I like to think of Medicaid as my free floating safety net -- there if I need it, but I can swim much better without it. Use the information in my other post to urge her to get out there and start exploring -- there are a lot more opportunities here than anywhere else in the country -- we've got more people starting more businesses, looking for more help per square foot. Just a matter of getting out there and finding the opportunities. If none present themselves for a while, hey, you've got Medicaid to fall back on in the meantime.
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