Medical Billing Blog

DOL Issues Final Rule on Worker Eligibility for Health Insurance

Posted by Scott Shatzman on Thu, Mar, 13, 2014 @ 09:03 AM

employer mandate resized 600The U.S. Department of Labor has issued a final rule that prohibits employers from requiring employees to wait more than 90 days after being hired before they can be covered by the Company’s sponsored health insurance plan. 

The rule will take effect on January 1, 2015 in conjunction with the scheduled start date for the employer mandate.  The new regulations set a 1,200-hour cap on the period of time an individual is required to work before becoming eligible for employer-sponsored insurance.

According to a Department of Labor announcement, the agency estimates that as many as 500,000 U.S.workers will benefit from the rule annually.  Employers retain the discretion of starting employees sooner than the expiration of the 90 day waiting period. 

After reviewing hundreds of comments from employers and employees alike, the only exception DOL approved as an allowance was for a "reasonable and bona fide" orientation period. Although the Department did not specify the meaning of a reasonable orientation period, a proposed companion rule states that an orientation period cannot last for more than one month.

There are some helpful vignettes or examples in the Final Rule describing how this rule would apply in various real world situations.


Thanks to Bill Finerfrock, Matt Reiter, and Zhaneta Mansaku for contributing this article.