How Long is the Employer Waiting Period for Health Insurance?
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If I left a job where I had health insurance and went to a new job, how long do I have to wait until they can offer me health insurance, 30 days or 60 days? I live in Ohio.
Bob Alouie
Your suggestion that an employee switching positions is half-right, and only right if they weren’t insured in their previous position. If they were, they may be better off getting COBRA than trying to find a plan on the marketplace. This is especially true if they’re older or they’re medical expenses are high.
Patti
If my employer offers a MEC for full time employees, is this only available at open enrollment regardless that my 90 days is up in March? In other words, my company offers low earners a MEC plan, and office staff a PPO. Office staff is offered insurance after 90 days of full time, lower earners are not eligible until open enrollment regardless when I started/
Is this compliant with ACA?
ObamaCareFacts.com
Good question, I am unsure of the answer on this one. Will try to research it.
James Vander Werff
IF I started a job while waiting for my 90th day for benefits I got sick around 55th day and out for a month. can they now make me wait a month more to make up the days I was out sick?
Diane
My daughter is working for Publix. She left a full time job with full time benefits because they promised her that they would make her ft when one of the ft employees left. That employee left and she is working 40 hours per week but is still categorized as part time. As a matter of fact some weeks she is doing 8 hours OT. She is afraid to speak up because she likes her job .They say she has to learn more about the company before she can interview for full time. She can’t afford healthcare so she has none. Are they allowed to do this?
ObamaCareFacts.com
There are measurement periods to consider when an employee goes from working part time hours to full time hours, so the employer isn’t necessarily in the wrong in the short term. You might want to refer to the Department of Labor website for more information on what is allowed and what isn’t. https://www.dol.gov/general/topic/workhours/parttimeemployment
With the affordable care act, it is all about measurement periods for health insurance. https://employeenavigator.zendesk.com/hc/en-us/articles/214822526-ACA-Setup-Measurement-Periods
Sue
I am a full time employee and a member of union 1199. I passed my probation of 90 days and have been working there for 4 months. Why are they telling me I have to wait for 5 months to get their group health inc.? I live and work in NY, if this matters
carol
Is the 90 days — calendar days or working days. My current employer is counting probation period of 90 working days which extends the period nearly 4+ months
Also: The waiting period for health insurance through an employer is a maximum of 90 days. “The exact waiting period is at the discretion of the employer.”….This is confusing…If the max is 90 days how is the waiting period at the discretion of the employer?
ObamaCareFacts.com
I am very sure it is 90 days period. 90 working days would make no sense with special enrollment and such, plus that isn’t how measurement periods work.
With that in mind, there are lots of special rules, so maybe one is applying to your job type?
Pheobe Blunt
Why do children get kicked out of the health care coverage annually? Can’t coverage continue without parent re enrolling them every year?
ObamaCareFacts.com
Hmm, well generally health contracts are annual contracts, so one has to renew each year. That could help explain why, although i’m not sure it is common practice to boot kids off of health insurance. Seems like that isn’t a written rule passed with the support of the people.
Elizabeth Lewis
With my employees hours varying weekly, is it possible to set a hourly waiting period in lieu of a 90 day waiting period? For example, offering coverage after they reach 360 work hours instead of 90 days from hire date?
shonda
My employer was taking medical insurance out my check before my 90 days were up. I couldn’t go to the doctors because they said I didn’t have insurance yet. Is it legal for them to take money while still in my 90 days??
victoria richard
my employer made me wait the 90 days then another 23 days to the first of the month. i thought they had a maximum of 90 not 90 plus 23 please help:)
ObamaCareFacts.com
I am with you, I was under the impression it was 90, not 90 and then 23. I am not sure what is going on with that. Final rule is pretty clear about the 90 day waiting period.
https://www.dol.gov/opa/media/press/ebsa/20140220-redfeg1.pdf
Robyn Williams
Hi,
My employer offered us 9 days to decide on healthcare coverage just out of the blue, after denying it to us for years. I was on vacation when it was offered, and when I came back it was no longer available to enroll. Is this legal? Also, they only offered it to 90 employees, when there are over 2,500 of us that are full-time in the same position. Is that legal?
Pat
I live in Ct. the waiting period is 1st of the month following 30 days. I was hired 5/2/16 what would be the effective date
Elizabeth
What about in California? For the year 2016 is it a 60 day waiting period or 90 days?
Sheree Baum
I work in the HR Dept and my employer had just changed the waiting period for a full-tilme worker as a new hire from 90 days to one year as of April 20, 2016. Can my company do this to new employees?
ObamaCareFacts.com
No they can’t do that as far as I understand it. They can choose a retrospect period of up to a year when offering coverage as an employer for the first time, but they can’t make new-hires wait a year (as far as I know). Anytime there is a specific legal question like this the best we can offer is general advice.
fdsfdsfds
gross obama care!
Raul
I had the same issue with the corner store company when I applied I asked about benefits they told me I believe 6 months I transferred to a different location only for them to tell me I had to wait be employed for one year. Only today that I discovered that according to my tax agent that this was highly illegal according to her for them not to provide me with insurance.
Mark Robertson
So is it illegal for my employer to have a mandatory 12 month waiting period for insurance coverage because I have been with them for 7 months and still not eligible.
ObamaCareFacts.com
Yeah, in general the waiting period can’t be more than 90 days (but this is once a person qualifies). If you were hired as full-time, that is 90 days from your start date… if you were hired as part-time, but your hours have become full-time, there is more wiggle room for the employer. I don’t think there is one simple answer (as you can see in the charts above, the details of measurement periods can get a little complex).
Dr. Chill
perhaps you were hired as a variable hour part time employee? If so, your employer may have decided to go with a 12 month measurement period. After the measurement period ends after 12 months, your hours are calculated from the previous 12 months (measurement period) to determine full or part time status. An average of 30 hours or more per week qualifies you as full time. That calculation happens during the administrative period which lasts one month immediately following the measurement period. If you are calculated as full time, your employer is obligated to offer you insurance at which time you either enroll or waive coverage. Immediately following the administrative period is the 12 month stability period where your effective insurance start date begins if you enrolled. During the stability period your full or part time status does not change – it remains constant even if you were calculated at full time and during the next 12 months you averaged less than 30 hours a week – and vice versa. If you were hired as a full time employee (e.g. salaried) then your employer must adhere to the waiting period that could be set at a maximum 90 days. That is how I understand it and may explain how your employer seemed to switch from 90 days to 12 months. They could have a 90 days waiting period for F/T EEs and 12 month measurement periods for P/T (variable or not). Don’t take my word for it though, it is best to do your research.