Starting January 1, 2014, for new group plans and at the first renewal for those group plans renewing after January 1, 2014, the waiting period may be no longer than 60 calendar days. A waiting period is the amount of time an eligible employee has to wait before coverage starts. This is for new or newly eligible employees and applies to all fully insured medical plans regardless of employer size.
The mandate also includes a special rule about individuals in a waiting period greater than 60 days and prior to the renewal date. If the employee is subject to a waiting period that exceeds 60 days and is within 60 days of the customer’s renewal date, it will no longer be valid. The employee must then be given the opportunity to elect coverage no later than the customer’s renewal date.
This mandate is extra-territorial, which means it applies to all insurance policies issued in the state of California and to all California residents regardless of the state in which their insurance contract is issued.
The following Carriers offer two options for a waiting period after January 1, 2014. FOMF* DOH** and FOMF 30 Days
- Anthem BlueCross
- Blue Shield
- Kaiser Permanente
- United Healthcare
Health Net offers three options for a waiting period after January 1, 2014. FOMF* DOH**, FOMF 30 Days, and FOMF 60 Days.
*FOMF is an acronym for First of the Month Following.
**DOH is an acronym for Date of Hire.
As always, Valley Employee Benefits is available to assist your growth efforts.