Waiting Periods Not To Exceed 90 Days

The Federal Government has announced new regulations regarding the 90-day limit on waiting periods for health coverage.

The final regulations require that no group health plan nor group health insurance issuer impose a waiting period that exceeds 90 days after an employee is otherwise eligible for coverage.  The rules do not require coverage be offered to any particular individual or class of individuals.

To ensure that eligibility conditions based solely on the passage of time are not used to evade the waiting period limit, the rules state that such conditions cannot exceed 90 days. Other conditions for eligibility are generally permissible, such as meeting certain sales goals, earning a certain level of commission, or successfully completing an orientation period.

Additionally, requiring employees to complete a certain number of hours before becoming eligible for coverage is generally allowed as long as the requirement is capped at 1200 hours. The rules also address situations in which it cannot be determined that a new employee will be working full-time.

The departments are issuing a companion proposed rule that would limit the maximum duration of an otherwise permissible orientation period to one month. This proposal will be open for public comment.

Both the final and proposed rules will be published in the Feb. 24, 2014 edition of the Federal Register and can also be viewed at the links below.

Final rule, http://www.dol.gov/opa/media/press/ebsa/20140220-redfeg1.pdf.

Notice of proposed rulemaking, http://www.dol.gov/opa/media/press/ebsa/20140220-redfeg2.pdf.

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