When Do I Become Eligible for Health Insurance From My Employer?

If your employer offers group health insurance as an employee benefit, it's in your best interest to familiarize yourself with the timetables regarding when you become eligible to participate in that plan. Certain aspects of health insurance eligibility are set by the employer, while others are set by state regulations.

Benefits Waiting Period

• Employers are free to institute a waiting period for all new workers before they are eligible to participate in the group health insurance plan. This waiting period may last as long as one year, but the most common duration is 60 days. Once you have been employed beyond the waiting period, and met any other company requirements related to participation in benefits programs, you may enroll in the group health insurance plan.

Hours Worked

• The number of hours you work each week is relevant to determining when you become eligible for your employer's health insurance plan. However, in this respect, your employer's definition of full-time versus part-time is irrelevant. Even if your employer refers to you as part-time, you may still qualify to enroll in the group health insurance plan. Each state maintains legislation clearly describing the criteria for identifying an eligible employee, and most states define one as an individual who works at least 25 to 30 hours per week.

Employee Designation

• Employers are free to exclude certain categories and classes of workers from participation in group health insurance plans. If your employee designation puts you within one such class, you will remain ineligible for group health insurance coverage until or unless your function within the company changes, placing you in an authorized category.

Open Enrollment

• If, after you initially passed your employer's waiting period, you chose not to enroll in the group health insurance plan, you will remain ineligible to sign up until the next open enrollment period. Open enrollment periods typically last 60 days and begin in the two months prior to the health insurance anniversary. However, if you experience a "life event" such as birth, death, marriage, divorce, or other similar status changes, a temporary window of eligibility opens up for 30 days following the qualifying event.