Health Care Reform
Final rules issued on ACA’s 90-day waiting period limitation
The IRS recently issued final regulations interpreting the Affordable Care Act (ACA) provision that prohibits group health plans from having an eligibility waiting period of more than 90 days. A waiting period is defined as the period of time that must pass before an otherwise eligible individual’s coverage under the employer’s group health plan becomes effective. This means that an eligible employee’s coverage under the plan must be effective no later than the 91st day (including weekends and holidays) following the start of employment. Under these final rules, a plan may still impose substantive eligibility rules, unrelated to the passage of time—for example, a requirement that the employee must be employed in a covered job classification, complete a probationary period of employment, or obtain a required license, unless those other conditions of eligibility are designed to be an end-run around the 90-day restriction.