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Text of Final Regs on 90-Day Waiting Period Limitation and Technical Amendments to Certain Health Coverage Requirements Under the ACA
Employee Benefits Security Administration [EBSA]; Internal Revenue Service [IRS]; U.S. Department of Health and Human Services [HHS] Link to more items from this source
[Official Guidance]
Feb. 20, 2014

85 pages. Excerpt: "These final regulations continue to define 'waiting period' as the period that must pass before coverage for an individual who is otherwise eligible to enroll under the terms of a group health plan can become effective. These final regulations also continue to include the clarification that, if an individual enrolls as a late enrollee or special enrollee, any period before the late or special enrollment is not a waiting period.... The final regulations set forth rules governing the relationship between a plan's eligibility criteria and the 90-day waiting period limitation.... Under these final regulations, after an individual is determined to be otherwise eligible for coverage under the terms of the plan, any waiting period may not extend beyond 90 days, and all calendar days are counted beginning on the enrollment date, including weekends and holidays. However ... the final regulations provide that a requirement to successfully complete a reasonable and bona fide employment-based orientation period may be imposed as a condition for eligibility for coverage under a plan.... The final regulations do not specify the circumstances under which the duration of an orientation period would not be considered 'reasonable or bona fide.' ... these final regulations provide that a former employee who is rehired may be treated as newly eligible for coverage upon rehire and, therefore, a plan or issuer may require that individual to meet the plan's eligibility criteria and to satisfy the plan's waiting period anew, if reasonable under the circumstances (for example, the termination and rehire cannot be a subterfuge to avoid compliance with the 90-day waiting period limitation).... The 90-day waiting period provisions of these final regulations apply to group health plans and group health insurance issuers for plan years beginning on or after January 1, 2015. For plan years beginning in 2014, the Departments will consider compliance with either the proposed regulations or these final regulations to constitute compliance[.]"

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