Home Page Group Health Individual Health Business Insurance Home and Auto Insurance

Blog by: Beth Ede, SPHR

Final Regulations Released: Implementing the Employer Shared Responsibility Provisions & 90-Day Waiting Period Limitation

 

Final Play or Pay (Employer Shared Responsibility) Regulations

On February 10th, the Treasury Department released the final regulations containing provisions to assist some applicable large employers and employers that offer most but not all employees coverage.

 

The final regulations defined various employee categories and clarified other specific provisions.  Most notably, the final regulations provided for a gradual phase-in of the employer shared responsibility provisions to “play or pay” and will generally apply to:

  • Applicable large employers with 100 or more full-time and full-time equivalent (FTE) employees starting in 2015; and
  • Applicable large employers with 50 – 99 full-time and FTE employees starting in 2016.

 

To qualify for this delay, the employer must provide an appropriate certification as described in the final regulations.  This form has not yet been released.  In addition, to avoid a penalty for failing to offer health coverage, applicable large employers with 100 or more full-time and FTE employees need to offer coverage to 70% of their full-time employees in 2015 and 95% in 2016 and beyond.

 

For detailed information and further guidance, see the final regulations and the IRS Q&A.



90-Day Waiting Period Limitation

Beginning for 2014, health care reform prohibits group health plans and insurance issuers from applying any waiting period that exceeds 90 days.  The final regulations recently released generally follow proposed regulations, with minimal changes.  These final regulations and a separate proposed rule provide further guidance on:

  • Counting of 90-day period
  • Reasonable and bona fide orientation periods
  • Rehired employees
  • Employees changing job classifications

 

For detailed information and further guidance, see the final regulations and the new proposed rule.

 

Remember to keep health care reform compliance focused on your radar.  If WA can be of further assistance to you, please feel free to contact us.

 

Posted 2:20 PM  View Comments

Share |


No Comments


Post a Comment
Name
Required
E-Mail
Required (Not Displayed)
Comment
Required


All comments are moderated and stripped of HTML.
Submission Validation
Required
CAPTCHA
Change the CAPTCHA codeSpeak the CAPTCHA code
 
Enter the Validation Code from above.
NOTICE: This blog and website are made available by the publisher for educational and informational purposes only. It is not be used as a substitute for competent insurance, legal, or tax advice from a licensed professional in your state. By using this blog site you understand that there is no broker client relationship between you and the blog and website publisher.
Blog Archive


View Mobile Version
HomeClaimsGet A QuoteContact Facebook Twitter LinkedIn Youtube Powered by Insurance Website Builder
174 Center Street | Winona, MN 55987
O: 507-452-3366 | TF: 800-657-4448
975 34th Avenue, Northwest Suite 302 | Rochester, MN 55901
O: 507-424-4400 | TF: 800-657-4448