Final Regulations on Waiting Periods Address Orientation Periods

The final regulations of the 90-day waiting-period limitation of the Affordable Care Act clarify how the waiting period will coincide with any employment-based orientation period. The orientation period must be a bona fide period in which the employer and employee evaluate whether the employee is suited to the job or during which standard orientation and training occurs.

A waiting period is defined as the period that must pass before an individual is eligible to be covered for benefits under a group health plan. All calendar days are counted beginning on the enrollment date, including weekends and holidays. If a group health plan conditions eligibility on an employee’s having completed a reasonable and bona fide employment-based orientation period, it will not violate the waiting period limit as long as the eligibility condition does not exceed one month, and the maximum 90-day waiting period begins on the first day after the orientation period.

The final regulations state that the one-month orientation period can begin on any day of a calendar month, and this period is determined by adding one calendar month and then subtracting one calendar day. For example, an employee begins working full-time for an employer on October 16. The employer sponsors a group health plan under which full-time employees are eligible for coverage after they have successfully completed a bona fide one-month orientation period. If the employee completes the orientation period on November 15, health plan coverage for the employee must begin no later than February 14, which is the 91st day after the end of the orientation period.

Employers must fully comply with the final regulations for plan years beginning on or after January 1, 2015.

If you have questions about waiting periods or orientation periods, call ASR Health Benefits at (616) 957-1751 or (800) 968-2449.