Do Substitute Teachers Get Health Insurance | All Details in One Guide

Do substitute teachers get health insurance? Yes, but it’s also the answer is no. Substitute teachers may or may not get this benefit at all. Other substitute instructors may collect teachers’ pensions if their state allows them. In some California cities, such as Fresno, Unions represent substitute teachers. These unions now have a wide range of advantages for the substitute teachers they represent.

It varies by district, but substitute teachers generally receive no compensation. The hourly wage they receive is only one-third of a typical classroom instructor.

The reason districts are always on the lookout for subs may surprise you, even though you must have the same credentials as a classroom teacher to be a substitute with health, dental, and vision insurance, accrual of sick time, legal assistance, and consult.

You will receive benefits and regular compensation if hired as a long-term substitute for more than 20 consecutive days. However, if that position becomes available and you wish to apply for it, you will still be classified out-of-district.

When it comes to employment, regular classroom instructors in unions will be given preference; you are an outsider as a substitute.

As you can see, your geographic location has a significant impact on your ability to find work as a substitute teacher.

Medical Insurance for Substitute Teachers

Do Substitute Teachers Get Health Insurance

If the district reasonably expects a replacement to work at least 10 hours per week, the substitute can enroll in TRS-Active Care. Granbury ISD does not consider hours worked in other school districts when evaluating whether a substitute is eligible for compensation.

A reasonable expectation of at least 10 hours per week for replacements does not guarantee that the district will receive 10 hours every week.

The school system weekly needs substitutes. It’s possible that you won’t get any assignments for a week or two. The district understands that you cannot take positions due to illness or other personal reasons.

If you’re a new replacement, you have 31 days from the date of your hire to enroll in or decline medical insurance. You must register or drop medical coverage as a returning substitute during open enrollment. A special enrollment event is required before you can enroll again in the following plan year unless you decline coverage.

Enrollment means that you will be responsible for the entire cost of your policy. With your membership form, you must make a one-month payment. The district will begin the termination procedure if you don’t pay your monthly premiums on time.

Who is Eligible to Apply for these Benefits?

Do Substitute Teachers Get Health Insurance

A 12-month measurement period, which matches the school year’s health plan year, is permitted under the Affordable Care Act. The summer vacation time must be omitted when determining substitute teachers’ average hours worked.

Therefore, it is possible to compute the average number of hours worked by substitute instructors in 12 months with a 10-week summer break using this formula: (rather than 52).

Alternate options in two broad categories

Long-term and short-term substitute teachers have different effects from state and federal standards (day-by-day).

Regular teachers who are likely to be out of the classroom for an extended period may recruit long-term replacements to cover their shifts (e.g., maternity or medical leave). Employees with long-term positions must work at least 30 hours a week.

They must offer coverage to them no later than the first entire calendar month of employment under the Affordable Care Act. Employees who work 30 hours or more per week must have insurance coverage.

Despite the Affordable Care Act’s mandate that the employee’s insurance coverage begins on the fourth month, Chapter 32B may demand earlier coverage. Therefore, some municipal employers do not require long-term substitutes to wait and provide coverage as soon as other employees are hired into benefits-eligible employment.

Intermittent Substitutes

Many substitute teachers work on a day-to-day basis. Substitutes who frequently work less than 20 hours per week will not be eligible for health insurance.

However, an issue arises when a daily replacement works more than 20 hours per week regularly, and especially 30 hours or more per week on average within the measuring period of the employer.

Unlike the ACA, which allows employers to defer determining whether a variable-hour employee qualifies for coverage until the end of the measurement period, Chapter 32B prohibits employers from delaying coverage if it is evident that an employee is “regularly” working more than 20 hours per week.

The employers should conduct regular reviews of the hours they work by variable-hour employees (such as daily substitutes) to assess whether these employees work at least 20 hours per week and whether you can anticipate them to do so in the future.

Assuming this is the case, Chapter 32B may mandate that they get the coverage even before the ACA does (at the end of the measurement period). 

Day-to-day replacements may work no more than 20 hours per week in several districts. To make sure that your substitutes are taken care of, you can provide health insurance for them and limit the hours worked by other employees. Adding a reporting requirement for replacement hours worked may also be beneficial.

Frequently Asked Questions

How do I become a substitute teacher?

State-to-State requirements differ. You can find the minimal standards for each state in the State-By-State Summary of the National Education Association. It would help verify substitute teacher qualifications with your state’s education department. For a complete list of DOE, click here.

Substitute Teachers United’s members are more than pleased to assist you with any queries about the certification process.

How much do substitute teachers make? 

There is a wide range of compensation rates for substitute teachers. The more money a substitute teacher makes every day, the more expensive living in that area.

For per diem (daily) substitutes, the current pay rate is between $20 to $190 per full day with half-days that you receive at half the speed of a full day. Substitute teachers get an average of $105 a day in the United States. Lengthy-term substitutes may be eligible for higher compensation if they remain in the same position for an extended time.

Can substitute teachers draw social security?

Social security benefits may be available to substitute teachers in states where retirement plans are unavailable. Social security often takes a back seat when substitute instructors collect teacher retirement benefits.

Charter schools, private schools, and Montessori schools that employ substitute teachers will very certainly be eligible to collect social security benefits for their labor.

Is it possible for substitute instructors to earn money during the summer?

Unemployment benefits may or may not be available to substitute teachers. Their state’s Unemployment Office can provide a more accurate answer.

Are there any similarities or differences between substitute teaching and regular teaching?

Many people have very varied experiences as subs. In other words, just like usual, full-time classroom teaching, Substitute teaching might differ per district.

Will I be a babysitter, or will I be teaching children?

It’s all up to the individual teacher. As long as they leave me with lessons to teach, you can either conduct or babysit. There is no one-size-fits-all approach to work. There is no such thing as a cookie-cutter subcontract.

Bottom line

As a substitute teacher, you may be eligible for an employee benefit plan if you work less than 100 days of creditable service. Your contributions may be returned to you with interest if you never reach full vesting in the CalSTRS Defined Benefit Program.

If you work for a company that participates in the Cash Balance Benefit Program, you are exempt. So, even if you work 100 days, you can choose to stay in the alternate program instead. Choosing a retirement plan that is right for you is a significant decision that requires careful consideration.

Substitute teaching is any activity that counts toward your service credit. It needs a credential, certificate, or permit, including teaching, vocational or guidance counseling, curriculum-related services, and administrative work.

CalSTRS says that Benefit Scheme members who are not under protection by Social Security or an alternative retirement program (such as the Cash Balance Benefit Program) need a federal law to have insurance by one or both programs.

School districts should examine health insurance requirements for substitute teachers in detail. Also, they must add local regulations to meet those needs. Consult municipal and labor counsel when formulating such policies, as is always the case.


Adam Grabois is an expert in all aspects of Insurance and Property with 20 years of experience. He is a licensed broker of all lines including property, casualty, life, and health. As a licensed adjuster, he is well-versed in all aspects of insurance, and he owns All Needs Insurance agency in Florida.

He attended Tufts University where he earned his undergraduate degree, followed by a Master's degree from Columbia University.

Adam shares his breadth of experience by helping many businesses and individuals manage risk and protect themselves financially. He now shares this with the audience of the "Pro Insurance Info" website.

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