Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding Employer/Employee Interaction and New Hire Waiting Period
Program Area: Small Business Health Options Program (SHOP)
Question: How will an employer select a new hire's waiting period prior to effectuating coverage?
Answer: An employer will establish the group's new hire waiting period policy during the initial application process. There will be a drop-down box in the online employer application where the employer will select the waiting period. The available options will be 0, 15, 30, 45, and 60 days. Because coverage for new hires is always effectuated on the first of the month, the maximum waiting period option will be 60 days to ensure an employee's waiting period does not extend beyond the maximum allowable period of 90 days. Issuers will not receive the waiting period start and end dates. Only the effective dates of coverage for new hires (incorporating applicable waiting periods) will be sent to Issuers.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 05, 2013
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