January Compliance Recap

Coverage first became available through the health marketplaces/exchanges on January 1, 2014, with a number of temporary provisions in effect to address some of the technical problems experienced in many of the marketplaces. Perhaps as a result of the …

What You Need to Know About the New Eligibility Waiting Period Provisions

benefit communicationThe 90-day maximum for eligibility waiting periods is effective as of the start of the 2014 plan year.  As employers are beginning to implement this new requirement, many have questions. For instance, what should employers do if they hired an employee under the prior rules?  

The 90-day limit applies as of the start of the 2014 plan year, even for those hired under the prior plan rules. This means that an employee who had worked 90 days by the start of the 2014 plan year must be covered as of the start of the year. Those who had worked fewer than 90 days must be credited with all time worked.

Here are some examples to help explain this scenario:

Ellen was hired October 2, 2013. Ellen’s employer has a calendar year plan and during 2013 it used a “first of the month after 90 days of employment” waiting period. Ellen must be offered coverage on January 1, 2014, because she will have completed at least 90 days of employment by that date.

Fred was hired October 22, 2013, to work part-time. Fred’s employer has a calendar year plan and during 2013 it used a six month waiting period. Fred must be offered coverage with an effective date on or before January 20, 2014, because that is Fred’s 91st day of employment. (It does not matter that Fred works part-time because the waiting period limit applies to both part-time and full-time employees.)

Jane was hired December 10, 2013, and Jim was hired January 29, 2014. Jane and Jim’s employer has a May 1 plan year and has been using a “first of the month after 90 days” waiting period. The employer is switching to a “first of the month after 45 days” waiting period as of May 1, 2014. Jane must be offered coverage with an effective date of April 1, 2014 (because the first of the month after 90 days is allowable for Jane’s employer until May 1). Jim must be offered coverage with an effective date of May 1, 2014, because Jim will have completed 90 days of employment by then.

United Benefit Advisors (UBA) has created a Patient Protection and Affordable Care Act (PPACA) Advisor that addresses a number of other recurring questions about this new provision that include, but are not limited to:

  • Does PPACA affect eligibility waiting periods?
  • May a plan use a 3-month waiting period?
  • May a plan impose a probationary period or cumulative service requirement before applying a waiting period?
  • May a plan allow employees to buy or bank hours toward an “hours of service for eligibility” requirement?

Click here to access the Frequently Asked Questions (FAQ) about waiting periods resource.

Why Your Disability Insurance Audit is So Important

For most employers, looking at the health insurance plan every year is a tradition. The numbers are reviewed, a bid is suggested (or not), and an analysis of the performance and incoming numbers is performed. Unfortunately, other ancillary lines are …

What “Play or Pay” Means in 2014

As we inch closer to full implementation of the Patient Protection and Affordable Care Act (PPACA), the nation’s employers are facing a deadline about whether or not they will “play or pay,” with regard to offering employee benefits. Unfortunately, many still do not fully understand the options and various implications of their PPACA-related decisions.

Attracting and Retaining Employees with Vision Benefits | PA Benefits

In the face of the Patient Protection and Affordable Care Act (PPACA), the most substantial change in decades to the U.S. health care system, many In fact, vision benefits are the most requested benefit after dental insurance, with more than 80% of American adults requiring some form of vision correction, according to VisionWatch—a study conducted … Continued

Attracting and Retaining Employees with Vision Benefits

In the face of the Patient Protection and Affordable Care Act (PPACA), the most substantial change in decades to the U.S. health care system, many employers are struggling to stay on top of health plan compliance while focusing on attracting and retain…

UBA’s Most Popular Tools to Alleviate PPACA Stress

To alleviate PPACA compliance anxiety, employers need resources that clearly explain which provisions affect them so they can make the best decisions. The following four guides will help you get started:

Current Developments With Health Care Reform

The health marketplaces/exchanges have enrolled many individuals, but are not without problems. Lawsuits continue to be filed about different provisions of the Patient Protection and Affordable Care Act (PPACA) and a number of bills have been introduce…

Additional PPACA Details Released

On January 9, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Department of the Treasury (IRS) issued Frequently Asked Questions – Part XVIII that provides additional information about requirements in seve…

 

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