Answers to your Employer Group Health Insurance Questions

Can the waiting period for new employees to be eligible for health benefits be 180 days?

No. The maximum wait for a new employee is 90 days. Period. An Employer can choose to offer coverage after any time less than 90 days; for example benefits begin after a 30 day wait, or 1^st of the month following 30 or 60 days. They CANNOT offer 1^st of the month after 90 days because 90 days is the Maximum wait time.

I own a small company with less than 10 employees; I am terminating an employee. Do I need to offer them the option to continue the health insurance?

Yes. While small groups (under 20 employees) are not subject to the COBRA law, small groups 2-19 are suject to Illinois Continuation. An Employer must offer coverage to the terminated employee for up to 12 months.

Can I waive the waiting period for my newly recruited/a top-notch executive who needs family coverage starting day one in order to take the job?

No. You cannot discriminate and offer different benefits to different employees or waive the waiting period. However, you can offer to pay their COBRA or purchase a short term policy to cover them under they are eligible for your company benefits.

Can an employee who changed her mind get onto our group health policy at any time?

No. Unless the employee has a QUALIFYING EVENT, such as loss of other coverage (through spouse or from a divorce) in the last 30 days, then they would not be allowed to enroll in the group plan at any time. The only exception is for the annual Open Enrollment, which is 30 days prior to the group’s renewal date. Anyone that had previously waived can jump on at this time.

I am thinking of dissolving the group health plan and giving money to the employees to go buy insurance on their own. Can I do this on a Pre-Tax basis?

Maybe. When the ACA plans became available in 2014, the Federal Government took away the ability for Employers to Reimburse employees on a Pre-Tax basis through an HRA arrangement (Health Reimbursement Account.) They even came out with a final ruling that said if you still had an HRA for individual policies after a certain date and were audited, the Employer would be fined and penalized.

As of Dec. 2016, a new HHS rule allows for deductions for Employers on Employee Contributions for individual health plans IF the new QSEHRA is established. For more info on these plans, contact CB Health Insurance 630-279-1739.