90-day Health Benefit Waiting Period Limitation

If you are a large or small employer offering health benefits to your employees, you need to make sure that your waiting period for such benefits does not exceed 90 days from hire date. You may need to review your policy manuals to make sure your eligibility period qualifications are updated in order to comply with these new ACA regulations.

The formal language below outlines your responsibilities.

90-day Waiting Period Limitation

PHS Act section 2708 provides that a group health plan or health insurance issuer offering group health insurance coverage shall not apply any waiting period that exceeds 90 days. Section 2704(b)(4) of the PHS Act, section 701(b)(4) of ERISA, and section 9801(b)(4) of the Code define a waiting period to be the period that must pass with respect to the individual before the individual is eligible to be covered for benefits under the terms of the plan.