The regulations provide guidance on waiting periods for plan years beginning on or after January 1, 2014. The regulations clarify that eligibility conditions that are based solely on the lapse of time are permissible for no more than 90 days. However, if a group health plan conditions eligibility on having worked a specified number of hours during a period (or working fulltime), and it cannot be determined whether a newly hired employee is reasonably expected to regularly work the required number of hours, the employer may utilize a measurement period as described in the Employer Mandate regulations to determine whether an employee has met the plan’s eligibility criteria.
The “measurement period” (as described in connection with the Employer Mandate) is not considered a waiting period under the rule that limits waiting periods to 90 days.
An eligibility condition may not be designed to avoid compliance with the 90-day waiting period limitation. The time period for determining whether a part-time, seasonal or variable hour employee is full time will not be considered to avoid the 90-day waiting period limitation if coverage can become effective no later than 13 months from the employee’s date of hire, plus the time remaining until the first day of the next calendar month (if the employee’s start date is not the first day of a calendar month). The regulations include a number of examples illustrating the application of these rules.
Finally, HIPAA notices of creditable coverage are not required after December 31, 2014.