Affordable Care Act: The Individual Mandate and What You Need to Know as a Temporary Employee


December: often referred to as “the most wonderful time of the year”, but also a time for the contingent workforce to make decisions about their health insurance for the coming year. It’s a complicated topic, and as a traveling clinician you likely have many questions. Let’s talk about the Affordable Care Act, and your increasingly important insurance options so you go into 2016 with a plan of action.

How does ACA affect the temporary staffing industry?

The Individual Mandate began in 2014, and requires most individuals to have health insurance for themselves and their dependents, or pay a penalty for non-compliance, as prescribed by IRS rules. In conjunction with the Individual Mandate, the Employer Mandate requires employers with 50 or more FTE employees to provide affordable, minimum essential coverage to their employees (including temporary staff that meets the qualification of FTE). Every person (individual) and staffing agency (employer) is different. Therefore, before choosing your insurance plan it is best to contact your financial and tax professionals to identify all of your options and requirements, depending on your unique situation.

Because health insurance is now required, travel professionals have to be savvier in terms of understanding the complicated world of insurance.  You must not only consider location and pay when negotiating new contracts, but health insurance must now be a priority. If you’re opting out of your staffing agency’s insurance, you need to be sure you’re covered somewhere else. The other popular option is the Federal Market Exchange: We’ll get into the pros and cons of both options below.

What are pros and cons of getting health insurance through the Market Exchange?


  • It is portable (take it with you on every travel assignment).
  • Don’t have to worry about coverage during vacation or gaps between contracts.
  • Insurance coverage options offered in the Market Exchange are required to comply with Individuate Mandate coverage requirements.
  • You choose the plan coverage and how much you pay based on your and your family’s needs


  • You must handle all the administrative duties of signing up and utilizing the coverage (if something goes wrong, you are responsible for resolving) and paying it directly with the insurance company.
  • Your preferred policy may have some limitations on coverage and may not be suitable in areas where you may travel for an assignment.

What are pros and cons of getting health insurance through staffing agency?


  • Administrative tasks of securing health insurance are taken care of for you. Cirrus Medical Staffing is a good example, as we have a dedicated department to help with enrollment and any questions or assistance required throughout the duration of your contract.
  • Continuous coverage if you stay with the same staffing agency. At Cirrus Medical Staffing, you have insurance on day one of your first assignment, and have continuous coverage as long as you have a gap no longer than 30-days between each assignment with us (provided you continue to pay the premium between assignments).
  • Most firms provide plans with nationwide in-network coverage. Cirrus Medical Staffing partners with the largest insurance firm in the U.S. – United Healthcare and UMR to provide more nationwide coverage.


  • If you jump around staffing agencies a lot, you have the potential for a lot of headaches to ensure you have continuous coverage. Taxes the following year will be more complicated, as you will have a lot more paperwork to provide proof of insurance for the previous year.
  • Your premiums and deductibles become more unpredictable if you work with multiple staffing agencies.

Now what?

Before the Individual Mandate, nurses could choose not to be insured for the duration of their assignments. This is still an option, but you could expose yourself to potential penalties. It is important that you understand what is required by law, determine what options you have, and consult a tax accountant before opting into or out of any kind of coverage each year. Once you have the facts about how you are personally affected by the ACA, think about what is important to you to help make a decision.

Here are a few things to do when negotiating a new travel contract:

  • Evaluate if the staffing agency is providing affordable, minimum essential coverage (the two requirements mandated by the IRS).
  • If the agency meets these requirements, determine the overall “hit” to your paycheck if you opt-in to the staffing agency’s plan (there are usually multiple coverage options, from the basics to the “Cadillac” package).
  • If you decide to opt-out of employer insurance, make sure you are covered elsewhere.

There are countless staffing agencies in the healthcare staffing industry, and each agency is different in terms of what they provide for health insurance. Some will completely forgo offering insurance and pay the penalty, thus requiring the traveler to seek their own coverage (NOTE: Cirrus Medical Staffing offers affordable and minimum essential coverage to all employees on day 1 of assignment).

If portability and longevity are your highest priority, the Market Exchange may be your best bet. If you want continuous coverage, but don’t want to deal with the headaches of enrollment or maintenance of health insurance, then choosing to work exclusively with one staffing firm might be preferable. No one can make this decision for you, but being informed will help you do what is best for you and your family. As always, we encourage you to check with your financial and tax advisors on these matters.

If you’re looking for a staffing agency known for quality and dependability, click here for more information about Cirrus Medical Staffing’s insurance options.