June 29, 2016

Waiting Period Final Reminder

This applies only to the new hires of groups whose effective dates we currently calculate.

As a final reminder, the Affordable Care Act (ACA) established rules around waiting periods for employees eligible for group coverage. Beginning July 1, Blue Cross and Blue Shield of Texas (BCBSTX) will no longer calculate the effective date that newly hired group members are eligible for group health coverage. Groups will be responsible for performing their own calculations (based on the new-hire waiting period as previously selected by the employer group and stated in the Group Contract) and providing us with the effective date of coverage for new hires.

To assist our groups with this change, we have developed the Effective Date Calculator, an optional tool for employers to use if they need help in selecting the correct effective date for a new hire. The tool asks questions based on the terms stated in the Group Contract (previously selected by the employer group) and then uses those responses to calculate the date.

Reminder: Beginning July 1, employers are required to provide effective dates for all new hires. The Effective Date Calculator tool is available on bcbstx.com for groups, if they need assistance with calculating the effective dates for new hires.

Beginning July 1, submitting an enrollment form without including the effective date will result in a processing delay.

In order to help groups use the tool, we have developed a job aid, which provides a step-by-step guide to using the Effective Date Calculator.

Note: Once the effective date has been calculated, this same date can be used to complete the effective date section in Blue Access for Employers or the Group Enrollment Application / Change Form.

This communication is intended for informational purposes only. It is not intended to provide, does not constitute, and cannot be relied upon as legal, tax or compliance advice. The information contained in this communication is subject to change based on future regulation and guidance.