Large employers must keep employee and dependent enrollment windows open for at least 31 days, may set a waiting period, and cannot deny timely coverage applications from eligible new employees or dependents.
Sec. 1501.606. EMPLOYEE ENROLLMENT; WAITING PERIOD. (a) The initial enrollment period for employees meeting the participation criteria under a large employer health benefit plan must be at least 31 days, with a 31-day annual open enrollment period. (b) A large employer may establish a waiting period. The employer shall determine the duration of the waiting period. (c) A new employee who meets the participation criteria may not be denied coverage if the application for coverage is received by the large employer not later than the 31st day after the later of: (1) the date employment begins; or (2) the date the waiting period established under Subsection (b) expires. (d) If dependent coverage is offered to the enrollees under a large employer health benefit plan: (1) the initial enrollment period for the dependents must be at least 31 days, with a 31-day annual open enrollment period; and (2) a dependent of a new employee who meets the participation criteria may not be denied coverage if the application for coverage is received by the large employer not later than the 31st day after the latest of: (A) the date on which the employment begins; (B) the date the waiting period established under Subsection (b) expires; or (C) the date the dependent becomes eligible for enrollment. (e) A late enrollee may be excluded from coverage until the next annual open enrollment period and may be subject to a one-year preexisting condition provision as described by Section 1501.102. The period during which a preexisting condition provision applies may not exceed 18 months from the date of the initial application. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.