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Health Care Reform: Agencies Issue Proposed Regulations on 90-Day Waiting Period Limitation

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March 2013

On March 21, the IRS, DOL, and Department of Health and Human Services issued proposed regulations on the 90-day waiting period limit that applies to employer group health plans beginning in 2014 under the Affordable Care Act. Some important aspects of the proposed rules include: 1) a clarification that 90 days does not equal three calendar months (90 days is 90 days, including non-business days); 2) it is acceptable to impose an eligibility requirement based solely on the lapse of time (e.g., a requirement to simply be employed full-time for a certain time period), as long as the time period does not exceed 90 days; 3) it is acceptable to impose other eligibility requirements that are not based on the lapse of time, even if some employees will need more than 90 days to satisfy the eligibility requirement, as long as the requirement is not designed to replicate a time-based standard of more than 90 days; and 4) an eligibility requirement that requires completion of a certain number of hours of service will not be considered a time-based standard if (a) the required hours of service are not greater than 1,200 and (b) once an employee reaches the required hours he or she is not required to wait more than 90 days to enroll. 

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