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.