LARGO Businesses across the nation, including the Pinellas County school district, are adjusting their health care plans to comply with the Affordable Health Care Act, but one variable may end up costing the school district millions: substitute teachers.

By 2015, the act requires the school district to provide health care benefits to all employees who work at least 30 hours a week. The school district has provided health care for employees who may work two different jobs in different school district departments that add up to 30 hours a week but not substitutes or other part-time employees who work randomly at different locations, Ted Pafundi, director of risk management and insurance for the school district, said at Tuesdays School Board workshop.

Last school year, there were 1,798 part time employees, including substitute teachers, working in instructional and administrative positions, according to the school district.

We have substitutes that work on a regular basis and over a certain period of time may average that 30 hours that will be eligible for benefits at an additional cost to the board, Pafundi said. Were looking at potentially millions of dollars of additional benefits coming in.

The school district does not have a way to track how many substitute work 30 hours a week but will begin working on projections of how the health care law will affect it, said Superintendent Michael Grego.

That information would also help identify where substitutes are working for long periods of time, the school system can fill that spot with a full-time teacher, said School Board member Rene Flowers.

Paying for substitute teachers health care is an issue that has left school districts across the nation scrambling. Many school districts have resolved the problem by hiring one or two permanent substitutes per school and ensuring that others who work in emergency situations do not work a full 30 hours, Pafundi said. Others in Nevada, Tennessee and New Jersey are limiting substitute teachers to only working four or fewer days a week.

Officials are working on a report about what to do next. Its an officials school administrators say they need to figure out.

A good substitute you can work every single day somewhere, said School Board Chairwoman Carol Cook.

School district officials also discussed other changes that will take effect in 2014, when all U.S. citizens will be required to have health coverage or pay a penalty that will rise in following years unless they receive qualified coverage from an employer, such as the school district. Next year, waiting periods for employer-sponsored health plans will be limited to 90 days, and there will be no annual limit on what a health plan pays for essential benefits, although daily and frequency limits may still apply.

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Health care law could inflate insurance costs for Pinellas schools