Proposed Guidance Issued on 90-Day Waiting Period

MAY 2013

For plan years beginning on or after Jan. 1, 2014, the Affordable Care Act (ACA) prohibits group health plans from applying any waiting period that exceeds 90 days. ACA’s 90-day waiting period limit applies to both non-grandfathered and grandfathered group health plans and health insurance coverage.

Although the rule is not in final form, the Departments will consider compliance with the proposed rule as compliance with ACA’s 90-day waiting period limit at least through the end of 2014.

To the extent a final rule or other guidance is more restrictive on plans and issuers than the proposed rule, the final rule or other guidance will not be effective prior to Jan. 1, 2015.

This Legislative Brief summarizes ACA’s 90-day waiting period limit and the guidance provided in the proposed rule. It also discusses how the waiting period limit relates to ACA’s shared responsibility provisions that will apply to large employers beginning in 2014.

For more information contact a Cottingham & Butler representative:
Cottingham & Butler Employee Benefits
Phone: 800.793.5235