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February 20, 2014 11:00 PM

ACA's 90-day limit on wait for health insurance finalized

Virgil Dickson
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    Nearly 500,000 people could soon see employer-provided health insurance start sooner when they begin new jobs, according to the U.S. Labor Department.

    That's the number of people that the federal agency anticipates will benefit annually from the final rule (PDF) it released Feb. 20 that prohibits workers from having to wait more than 90 days before becoming eligible for healthcare coverage. The mandate was part of the Patient Protection and Affordable Care Act. The rule also places a 1,200-hour cap on the length of time a person can be required to work before becoming eligible for healthcare coverage. The regulation kicks in Jan. 1, 2015.

    A total of 5.1 million new employees receive health insurance coverage through private- or public-sector employers annually, according to the Labor Department.

    Many companies, in commenting on the rule, said they can only begin coverage on the first day of a month, meaning that coverage for their new employees wouldn't be effective until the first day of the first month following a 90-day waiting period rather than on the 90th day.

    Other companies requested that plans be permitted to impose a waiting period of three calendar months instead of 90 days, claiming it would be less confusing to participants and easier for plans and issuers to administer.

    The Labor Department denied making allowances for either scenario, noting that the 90-day period is law, and those days include weekends and holidays.

    The policy also clarifies that a former employee who returns is to be treated as new, and must again wait up to 90 days. The same applies to an individual who held a position at the company who was not eligible for coverage and then transitioned to a role that was.

    However, the policy did leave open one potential loophole. It allows the 90-day clock to kick in after a “reasonable and bona fide” orientation period, but it doesn't define what that means. The Labor Department released a companion proposed rule (PDF) that declares an orientation can last no more than one month.

    Specifically, one month is calculated by adding one calendar month and subtracting one calendar day, measured from an employee's start date. So if an employee's start date is May 3, the last permitted day of the orientation period is June 2.

    The agency is accepting comments on this proposal through May 21.

    Follow Virgil Dickson on Twitter: @MHvdickson

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          • - Luminaries
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        • Social Determinants of Health Symposium
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      • Virtual Briefings
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        • - Value Based Care
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        • - AI and Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
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