SHOULD I STILL KEEP THE LATE ENTRANT LANGUAGE IN 2014-2015?

Yes, it is advised you keep the language for 2014-2015. Although the late entrant can no longer be subject to pre-existing condition limitations, the plan can still impose enrollment requirements for any late enrollees. Such requirements include not permitting them to elect coverage until open enrollment, unless they have a special right designated to them by HIPAA guidelines. Note, HIPAA does not require a plan to have this late entry language, however if the language is included, it must also have the Special enrollment rights listed.

Many plans are offering benefits through a cafeteria plan; which offer pretax payroll deductions and do not permit midyear election changes without qualifying events (in accordance with IRC §125.) However, recently there has been a transition rule issued for non-calendar year plans for a single year that permits them to amend their plans in order to allow for mid-year election changes, without qualifying events. This is a temporary transition rule for one year and excludes non calendar year plans.

Also, if they are not offering pretax contributions, they could remove the late entry provision, nevertheless, if they are fully insured it is advised that they check with the insurer first. The Public Health Service Act specifically lists that health insurance issuers are permitted to limit enrollment to only open enrollment/special enrollment.

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