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The Wagner Law Group Description 

The Wagner Law Group, A Professional Corporation, is a nationally recognized ERISA & employee benefits, estate planning, employment, labor & human resources practice. 

 

Established in 1996, The Wagner Law Group has 19 attorneys engaged exclusively in employee benefits, estate planning and employment law. Five of our attorneys are AV rated by Martindale-Hubbell as having very high to preeminent legal abilities and ethical standards. The firm is among the largest ERISA boutiques in the country. Our practice is national in scope, with clients in more than 40 states and several foreign countries.

 

 

 

 

 

Contact Info

The Wagner Law Group

 

Massachusetts Office 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110


Florida Office 

Tel: (561) 293-3590
Fax: (561) 293-3591
7121 Fairway Drive
Suite 203
Palm Beach Gardens, FL 33418

 

New York Office

Tel: (716) 650-5987

Fax: (716) 633-0301

333 International Drive

Suite B-4

Williamsville, NY 14221

 

San Francisco Office

Tel: (415) 625-0002

Fax: (415) 829-4385

315 Montgomery Street

Suite 902

San Francisco, CA 94104

 

www.wagnerlawgroup.com

 

 

 

 

September 20, 2012 

 State and Federal Law Alert

 

 

 

IRS Issues Guidance on PPACA's 90-Day Group Health Plan Waiting Period Limitation

 

 

 

The IRS has issued Notice 2012-59, which offers temporary guidance on the prohibition in the Patient Protection and Affordable Care Act ("PPACA") against group health plan waiting periods of more than 90 days. In particular, the Notice defines the term "waiting period" and specifies the timeframe during which employers may determine whether newly-hired, variable hour, or seasonal employees are eligible for group health plan coverage.

 

The Notice defines "waiting period" as the period of time that must pass before coverage for an employee or dependent becomes effective. While eligibility conditions based solely on the passage of time are permissible for no more than 90 days, other eligibility conditions are generally permissible, unless they are designed to avoid compliance with the 90-day limitation. The Notice clarifies that if an employee may elect coverage that would begin within the 90-day waiting period, no violation will occur simply because the employee takes more time to elect coverage.

 

If group health plan eligibility is conditioned on an employee working full-time (or regularly working a specified number of hours per period) and it cannot be determined whether a newly-hired employee will work the required number of hours, the plan may use a measurement period to determine if the employee satisfies the plan's eligibility condition. However, any measurement period must be consistent with the requirements for determining a newly-hired employee's full-time status under PPACA's employer mandate. (See the Alert of 9/13/2012.) Also, the measurement period cannot exceed 13 months from the employee's start date, plus the number of days until the first day of the next full calendar month.

 

The 90-day limitation on waiting periods becomes effective for plan years beginning on or after January 1, 2014. Unlike PPACA's employer mandate, which applies only to certain large employers, the 90-day limitation applies to all employers regardless of size. While the guidance offered in the Notice may be relied on at least until the end of 2014, employers should be aware that additional guidance may be issued for later years. The Notice is accessible at: http://www.irs.gov/pub/irs-drop/n-12-59.pdf.

 

 

 

This Newsletter is protected by copyright. Material appearing herein may be reproduced with appropriate credit.

  

Pursuant to Internal Revenue Service Circular 230, we hereby inform you that any advice set forth herein with respect to US federal tax issues is not intended or written by The Wagner Law Group to be used and cannot be used, by you or any taxpayer, for the purpose of avoiding penalties that may be imposed on you or any other person under the Internal Revenue Code.

 

This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.  This material is not to be construed as legal advice or legal opinions on specific facts. Under the Rules of the Supreme Judicial Court of Massachusetts, this material may be considered advertising.