{
  "$schema": "https://clarusclm.com/schemas/policy-rollout/v1.json",
  "template_id": "benefit-eligibility",
  "version": {
    "body_text": "BENEFIT ELIGIBILITY POLICY\n\n1. FULL-TIME ELIGIBILITY\nEmployees scheduled to work at least 30 hours per week are classified as full-time and are eligible for the full benefits package: health, dental, vision, life insurance, short-term and long-term disability, 401(k), and paid time off.\n\n2. PART-TIME ELIGIBILITY\nEmployees scheduled to work between 20 and 29 hours per week are classified as part-time and are eligible for: 401(k) participation after one year of service, pro-rated paid time off, and any benefits required by state or local law (paid sick leave, transit benefits in qualifying jurisdictions).\n\n3. WAITING PERIOD\nNew full-time employees are eligible for health, dental, and vision benefits on the first day of the month following 30 days of employment. Life and disability coverage begins on the same date. 401(k) eligibility begins on the first day of the calendar quarter following 90 days of employment.\n\n4. ACA FULL-TIME RULE\nUnder the Affordable Care Act, employees who average 30 or more hours of service per week (or 130 hours per month) over a measurement period are treated as full-time for ACA purposes regardless of formal classification. ACA full-time employees are offered minimum essential coverage that meets affordability and minimum value standards.\n\n5. QUALIFYING LIFE EVENTS\nQualifying life events allow mid-year benefit elections changes: marriage, divorce, birth or adoption, death of a covered dependent, change in employment status, change in residence affecting eligibility, and gain or loss of other coverage. Documentation must be submitted within 30 days of the event.\n\n6. DEPENDENT ELIGIBILITY\nEligible dependents include legal spouse, domestic partner (where recognized), and children under age 26. Eligibility documentation (marriage certificate, birth certificate, adoption decree) is required at enrollment.\n\n7. STATE-SPECIFIC ADDITIONS\nState-mandated paid family and medical leave (CA, NY, NJ, MA, WA, CT, RI, OR, CO, MD, DE) is provided in addition to company benefits. Employees in these states should consult the state-specific paid leave addendum.\n\n8. SEPARATION\nUpon separation, COBRA continuation is offered for federal-COBRA-covered benefits. State mini-COBRA applies in qualifying states. The COBRA election notice is sent within 14 days of the qualifying event.",
    "change_summary": "Initial 2026 benefit eligibility policy."
  },
  "rollout": {
    "audience": {
      "jurisdiction_codes": [],
      "department_ids": [],
      "employee_group_scope": "all"
    },
    "mandatory": true,
    "acknowledgment_required": true,
    "comprehension_check": {
      "enabled": true,
      "questions": [
        {
          "prompt": "An employee scheduled for 28 hours per week is eligible for the full benefits package.",
          "answer_type": "single_choice",
          "options": ["True", "False"],
          "expected_index": 1
        },
        {
          "prompt": "How many days does a qualifying life event allow for documentation submission?",
          "answer_type": "single_choice",
          "options": ["7 days", "14 days", "30 days", "60 days"],
          "expected_index": 2
        },
        {
          "prompt": "Under the ACA, an employee who averages 130 hours per month over a measurement period is treated as full-time for ACA purposes regardless of formal classification.",
          "answer_type": "single_choice",
          "options": ["True", "False"],
          "expected_index": 0
        }
      ]
    },
    "ai_classification_hints": {
      "summary": "Full-time and part-time thresholds, waiting period, ACA full-time hours rule, qualifying life events, dependent eligibility documentation, state-specific paid leave, and COBRA continuation.",
      "regulatory_citations": [
        "Affordable Care Act 4980H",
        "Internal Revenue Code 4980H",
        "ERISA 510",
        "COBRA (29 USC 1161 et seq.)",
        "CA PFL, NY PFL, NJ FLA, MA PFML, WA PFML, CT PFMLA, RI TCI, OR PFMLI, CO FAMLI, MD FAMLI, DE PFMLA"
      ],
      "key_terms": ["full-time threshold", "waiting period", "ACA full-time", "qualifying life event", "COBRA continuation"],
      "manager_briefing": "Confirm scheduled hours match formal classification at hire and reclassify when hours shift. Route qualifying life event documentation to People within 30 days. Do not promise benefits before the waiting period; refer questions to People.",
      "exception_examples": ["leave of absence affecting full-time hours", "seasonal employee approaching ACA threshold", "domestic partner enrollment in non-recognizing state", "gain of other coverage mid-year"]
    }
  }
}