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A Reader Asks: Can New Employees Be Forced To Wait 90 Days For Coverage?

Q. My daughter changed jobs, and now she has to wait 90 days for coverage. Is this legal? She had coverage in her old job.

A. It’s legal. Under the health law, employers can require new hires to wait up to 90 days for their health insurance benefits to start once they become eligible for the employer plan.

The wait may be even longer because employers can delay eligibility for up to an additional month to allow for an orientation period during which the employee goes through training, and the employer and employee evaluate whether the new job is a good fit. Eligibility for coverage can also be delayed if it’s contingent on becoming licensed or achieving sales or commission targets, among other requirements. 

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A Reader Asks: Can New Employees Be Forced To Wait 90 Days For Coverage?

Ninety days may seem like a long time, but before the health law passed there were no federal limits on waiting periods, although a handful of states impose them, says Amy Bergner, managing director of PwC’s Human Resource Services practice. 

Your daughter has other coverage options during this waiting period. She can apply for a plan on the health insurance exchange and, since she doesn’t yet have an offer of health insurance from her new employer, she may qualify for subsidies to make coverage more affordable, says J.D. Piro, who leads the health law group at Aon Hewitt. Subsidies are available to people with incomes up to 400 percent of the federal poverty level (currently $45,960 for an individual). Even though open enrollment for the exchanges has closed, losing job-based coverage is a “qualifying event” under the law that allows her to apply for exchange coverage.

She may also be eligible to continue her coverage through her own employer under the federal law known as Cobra, although that coverage is likely to be more expensive than exchange coverage. She may be able to join your health plan as well now that young adults are allowed to stay on their parents’ plans until they turn 26.

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

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