Waiting Period and Orientation Period
Final regulations were released on February 24, 2014 confirming and clarifying earlier guidelines relating to waiting
periods for group health plans under the Affordable Care Act (ACA). The general rule is that group health plans may not
apply a waiting period that exceeds 90 days. The term “waiting period” means the time that elapses before coverage
for an "otherwise eligible" individual becomes effective. Waiting periods are not required—coverage can begin
immediately—but under the ACA, if a waiting period is imposed, it cannot be longer than 90 days.

Otherwise eligible
An individual is “otherwise eligible” to enroll in a group health plan when he or she meets the plan’s substantive
requirements. Examples of substantive eligibility conditions include (1) obtaining a job-related licensure, or (2)
moving into an eligible job classification.
A third substantive eligibility condition described in the new proposed rules published in February 2014 is the
orientation period.

Orientation period
The proposed rule will allow employers to establish a period of time during which the employee and employer
can evaluate whether the employment situation is satisfactory to each party. This is a time when standard
orientation and training activities can take place. If an employment-based orientation period is imposed, it
must be “reasonable and bona fide," which, under the rules as proposed, can be no longer than one month. The
waiting period then begin on the next day.
The one month orientation is calculated by adding one calendar month and subtracting one calendar day. For
example, if an employee starts on May 3rd, the last day of the orientation period is June 2. The 90-day waiting
period would then begin on June 3rd.
If there is no corresponding date using this calculation, then the last day of the next calendar month is used. For
example, if an employee starts on January 30, the last day of the orientation period is February 28 (or February
29 in a leap year). The 90-day waiting period would begin March 1.
The guidance limiting the length of employment-based orientation periods to one month are not yet final. Formal
comments are due by April 25, 2014, and final rules may be issued at some time thereafter.