The U.S. Departments of Treasury, Labor and Health and Human Services issued another round of regulations on health care reform requirements. These regulations address the maximum waiting period that may be applied for health coverage, confirm the elimination of preexisting condition exclusions, and eliminate the need to issue Certificates of Creditable Coverage.
Waiting Period
A group health plan may not impose a waiting period for coverage that exceeds 90 days after the employee is otherwise eligible for coverage. Waiting periods less than 90 days are permitted, and employers can provide time after the waiting period to enroll in coverage, so long as the coverage is effective as of the 90th day.
The regulations do not require employers to offer coverage to any particular individual or class of individuals. Employers may continue to place conditions on eligibility, such as being in an eligible class of employees, completing an orientation period, meeting certain sales goals, or completing a certain number of hours worked (not more than 1200 hours). The rules are intended to provide that coverage must be effective not more than 90 days after satisfaction of the eligibility criteria.
Certificate of Creditable Coverage
The regulations confirm that group health plans may no longer impose preexisting condition limitations based on a health factor. Since the purpose of HIPAA Certificates of Creditable Coverage was to document coverage to be applied against preexisting condition limitations imposed by a health plan, these certificates are no longer needed. The regulations state that HIPAA Certificates of Creditable Coverage will no longer be issued after December 31, 2014.
Orientation Period
A separate set of proposed rules issued with the final regulations would limit the maximum time of an orientation period to one month.
The new regulations were an anticipated piece of guidance for employers to use in implementing health care reform requirements.
