Final and proposed rules issued on the ACA's 90-day waiting period

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By Milliman Employee Benefits Research Group | 10 March 2014

CAB 14-3: Group health plans and group health insurance must not impose a waiting period longer than 90 days for employees and their dependents, under a final rule issued by the IRS, the Department of Labor, and the Department of Health and Human Services. The final rule’s waiting-period limitation, which is part of the Affordable Care Act (ACA), applies to plan years beginning on or after Jan. 1, 2015. Other provisions of the final rule apply to plan years beginning on or after Apr. 25, 2014, with plan sponsors and insurance issuers deemed in compliance during 2014 if they satisfy the requirements of the March 2013 proposed rule.

The agencies also separately issued a proposed rule on “employment-based orientation periods” to address concerns raised by some employers about the effect of the waiting-period requirement and bona fide orientation periods. Under the proposed rule, an employer’s orientation period may be no longer than one month, determined by adding one calendar month and subtracting one day to the waiting period. Employers may rely on the proposed rule for 2014, and a final rule will not be effective prior to 2015.