Waiting period calculator: when does a new hire’s health coverage have to start?
Enter a hire date and your plan’s waiting rule to see the coverage start date and whether it stays inside the federal 90-day limit. Built for HR teams that set up new-hire eligibility and want to check it before the carrier or an auditor does. For variable-hour staff, use our measurement period calculator instead.
Check a waiting period before you put it in the plan.
Pick the rule your plan uses, change any field, and the dates update as you type.
Usually the hire date. If the plan first requires a job-related condition, such as a minimum number of hours or a license, use the date that condition is met.
Plan wording varies, so match the calculator to your plan document and carrier contract.
Calendar days, including weekends and holidays. Common choices are 0, 30, 60 and 90.
Your dates
A planning estimate, not legal advice. Check the result against your plan document and carrier eligibility rules.
What is the 90-day waiting period limit?
The Affordable Care Act bars a group health plan from making an otherwise eligible employee wait more than 90 calendar days for coverage to start. The count includes weekends and holidays, and coverage has to begin no later than the 91st day. A plan can still set eligibility conditions first, such as a minimum number of hours or a job-related requirement, and the 90 days run once those conditions are met.
How do common waiting rules compare?
Three rules cover most plans. Coverage on the eligibility date has no wait. A set number of days starts coverage after that many days. A first-of-the-month rule waits a set number of days, then starts coverage on the next first of the month. Hire on October 15 with a 30-day first-of-the-month rule and coverage starts December 1, a wait of 47 days. The same rule set at 90 days will usually run past the limit, because the roll to the first of the month adds days on top of the 90.
Where do employers go wrong?
Most problems are mismatches, not bad intent. The enrollment guide says one thing, the plan document says another, and the carrier contract has its own eligibility rule. Rehires, employees who change status and staff in a measurement period each need their own check. Our enrollment services keep the rule consistent from the plan document through the enrollment screens.
Common questions
Does the 90 days count business days?
No. It counts calendar days, including weekends and holidays. Coverage has to start no later than the 91st day after the employee becomes eligible.
Can we use a first-of-the-month rule?
Yes, as long as the total wait stays within 90 days. A first-of-the-month rule after 60 days generally fits. After 90 days it generally does not, because the roll to the first of the month adds days past the limit.
Does the limit apply to part-time employees?
It applies to employees who are eligible under the plan’s terms. A class that is not eligible, such as part-time staff under a written eligibility rule, is not on the clock until it becomes eligible. For variable-hour employees, the measurement period method decides when eligibility begins.
What happens if our waiting period is too long?
The plan is out of line with the ACA waiting period rule, which can carry excise taxes, and the fix usually means amending the plan terms and the carrier contract. Have your counsel review any plan that currently waits longer than 90 days.
Is this calculator legal advice?
No. It is a planning tool that applies the 90-day calendar count to the rule you enter. Plan language, state rules and carrier eligibility requirements can change the answer.
Talk to us about waiting periods and eligibility
Book a 30-minute call and we will check your waiting period against the plan document and the carrier contract. Visit us at 41000 Woodward Avenue, Suite 350 East, Bloomfield Hills, MI 48304, or call 248.370.8853.
Unhappy With Your Current Broker?
Switching to CFH takes one signed letter. Your carrier, plan, ID cards and payroll deductions stay the same.
Related guides and tools.
Waiting Periods for Group Health Coverage
The 90-day limit, common waiting period designs, and the first-of-the-month trap.
Free Employer Benefits Tools
The full set of free calculators for employers.
Compliance and Legislative
Deadlines and rules that apply to your plan.
Employer Size Compliance Checker
See which federal rules apply at 20, 50 and 100 employees.
MLR Rebate Calculator
Estimate a medical loss ratio rebate on your group policy.
Special Enrollment Deadline Calculator
Find the last day to request coverage after a life event.
Laws and rules referenced
42 U.S.C. § 300gg-7 — Prohibition on waiting periods longer than 90 days
45 CFR 147.116 — 90-day limit on waiting periods for group health plans
This tool gives estimates for education, not tax or legal advice. Rules change, so confirm your situation with a qualified advisor.
An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.
Switch to CFH. Unhappy with your broker? Your employees won’t notice. You will. →