The U.S. Departments of Health and Human Services, Labor, and the Treasury (together, the “Agencies”) issued final regulations under the Affordable Care Act (the “Act”), which clarify that the maximum allowed length of an employment-based orientation period that may precede the 90-day waiting period for coverage to become effective under a group health plan is one month. The regulations explain how the one-month maximum will be applied based on various employment start date scenarios. The preamble to the regulations also clarifies the interplay between the 90-day waiting period requirement and the employer shared-responsibility provisions of the Act (the so-called “play-or-pay rules”), confirming that compliance with the 90-day waiting period (and orientation period) requirements is not determinative of compliance with the play-or-pay rules. The play-or-pay rules penalize employers that fail to provide affordable minimum value coverage to certain newly-hired full-time employees by the first day of the fourth full calendar month of employment.
The regulations apply to group health plans and group health insurance issuers for plan years beginning on or after January 1, 2015. A copy of the regulations is available here.