Posted in Offering health benefits | by: Lauren Fifield

Wait a Minute. What’s Up with the 90-Day Employer Waiting Period?

The waiting period might look like just another term in the game of jargon gymnastics. But when someone new joins your team, it’s really important to understand all the ins and outs of this key concept. Rolled out by the Affordable Care Act (ACA) in 2014, the requirement states that companies offering health insurance must make it available to employees within 90 days after they start. Sounds simple enough, right? Not so fast. This article will explain why you should care about the waiting period, what it takes to comply, and how to use the timeframe to underscore the values your company believes in.

What is it?

In essence, the period is a block of time your employees have to wait before health coverage kicks in. It streamlines access to benefits by preventing your team from having to wait forever before receiving insurance.

Okay, but why does it matter?

To start, you need to know about the waiting period because you have to stick to it. Whenever a new teammate starts, it’s important to tell them the exact date their coverage begins. If insurance is activated after their first day, knowing that simple fact will help them prevent a lapse in coverage for themselves and their families.

The period is also a meaningful way to reinforce your company culture — the same one that attracted your employee to your company in the first place. Whether it’s feeling more relaxed on that first daunting day or not having to worry about all the splintery details that go into enrolling in benefits, you want people to feel like they’re being taken care of whenever they interact with you. A warm welcome also helps people feel more in control at a time when things are already so new and tumultuous.

And finally, you can wield it as a tool. If you have a company that has high turnover, you may consider lengthening the waiting period closer to the 90-day upper limit. But if the opposite situation is true, it may be wise to begin benefits right after your new team member starts.

How long should I wait?

90 days is the maximum amount of time you can wait before activating your employee’s health benefits. However, showing your team that you truly care about their well-being means never (ever) waiting until the last minute.

Pro tip: Our team of benefits advisors recommends that you begin coverage within one month after your new hire starts.

Whether or not this is feasible depends on your carrier, so make sure you identify the earliest possible date that you can set up your employee on the company plan. You can surface this information by visiting your carrier’s website or by asking your broker straight directly.

Can I have different waiting periods for different groups of employees?

Yes! You can assign different waiting periods to different groups in your company. The only caveat is that you need to make sure each group is treated in the same way and officially established as a non-discriminatory class of employees in your benefits plan. For example, if you have a different waiting period for hourly workers, that would fit the bill.

 

ACAchecklist

 

Do the 90 days include work days, calendar days, or something else entirely?

Under the law, the 90 days are just that — 90 consecutive calendar days. That means weekends and holidays are swept up in the final count. If the 91st day falls on a non-workday, coverage needs to be switched on before that day or on the exact weekend or holiday the 91st falls on.

Pro tip: 90 days does not equal three months. There are a few other mentions of a three-month waiting period in the ACA, but it’s referring to a completely different thing.

What if my employee needs coverage ASAP?

Because of the individual insurance mandate, your new team member should already have coverage. If they don’t, load them up with the following resources to help them get the insurance they need until the company insurance kicks in:

  • Healthcare.gov Marketplace plan: Thought your team could only sign up for health insurance during open enrollment? Since losing insurance is a qualifying life event (QLE), they can enroll through something called a special enrollment period. Your employee can confirm their eligibility right here.
  • COBRA: If your worker qualified for COBRA from their previous job, they may still be able to receive coverage through the program. Check out this Department of Labor site for more information.
  • Interim health insurance: Short-term insurance plans usually don’t satisfy many of the ACA requirements. However, it can be a good fill gap if neither COBRA or a Marketplace plan are options.

Good things come to those who know about the waiting period. A more comprehensive knowledge will help you get in better shape whenever a new teammate comes on board. The requirement will make a lot more sense, and your team will be able to rinse away their worries about getting health insurance — well before the clock runs out.

About Lauren Fifield

Lauren is a health tech veteran and a licensed producer of accident, health, and life insurance. She currently leads benefits advising and operations at Gusto. You can get in touch with Lauren here.