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ACA: Health benefit waiting periods capped at 90 days

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in Employee Benefits Program,Human Resources

Employer-sponsored group health plans cannot impose waiting periods that exceed 90 days after an employee is otherwise eligible for insurance coverage under a final Affordable Care Act rule issued Feb. 20 by the Obama administration.

“This is a common sense measure that helps workers access employer-sponsored health insurance while providing employers flexibility,” said Assistant Labor Secretary Phyllis C. Borzi.

The rules don’t require coverage be offered to any particular individual or class of individuals, and other conditions for eligibility are generally permissible, such as meeting sales goals, earning a certain level of commission or completing an orientation period. (Under proposed rules that aren’t yet final, orientation periods could generally not last longer than one month for coverage eligibility purposes.)

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 1,200 hours. The rules also address situations in which it cannot be determined that a new employee will be working full time.

Read the final rules at the Department of Labor's website.

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