90-Day Waiting Period

Limit on Employee Coverage Waiting Periods

The 90-day waiting period provision of the Affordable Care Act (ACA) mandates that the waiting period before an employee who is otherwise eligible to enroll can become effective under a group health plan beginning on or after January 1, 2014, cannot exceed 90 days. This provision applies to employees who are reasonably expected to work full time at the date of hire.*

Employers that do not comply with this provision can face penalties including a fine of $100 per day per employee, possible enforcement action from the Department of Labor, and potential employee litigation.

BeneTrac Has Your Solution

It can be complicated and time-consuming to track the time elapsed after each employee’s eligibility date and to determine which employees count as full-time under this regulation. BeneTrac, the industry leader in Web-based enrollment and employee benefits administration solutions, makes complying with the 90-day waiting period requirement simple by:

  • Determining the number of employees who need to be offered coverage.
  • Automatically managing waiting periods for newly eligible employees.

*If it cannot be determined when the employee is hired if full-time status will be met, the employer may impose a measurement period between 3 and 12 months in length to determine whether the employee is full-time. This may be followed by an administrative period allowing the employer time to enroll the employee into coverage; however, the total duration of the measurement and administrative periods may not exceed 13 months from the employee’s start date. The employer may then verify that the employee’s hours of work are consistent with those of a full-time employee during a stability period lasting at least six months or otherwise equal to the measurement period. 

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