Grandfathered Plans

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If you like your health plan, you can keep it…IF you follow these rules.

Overview

Before and after the passage of the Affordable Care Act, President Obama has repeatedly said “if you like your health plan, you can keep it”. Though it was misunderstood by many consumers, media outlets, and even our elected officials, there is a provision in the law that allows plans that were in place when the law was signed on March 23rd, 2010 to be “grandfathered” and avoid many of the new market rules, most of which went into effect on the plan’s renewal date in 2014.

Though the final rule on grandfathered health plans has been in place since June 17, 2010, it didn’t get a lot of attention until millions of consumers started receiving cancellation notices from their insurance companies in October of 2013. Bowing to political pressure, media backlash, and declining approval ratings, the administration announced in November that people could, in fact, keep their health plan – even if it’s not grandfathered – and insurance companies can renew the plans in 2014. However, states have the right to override this decision, and many states that developed their own exchange have done just that – consumers will be required to switch to the new ACA-compliant plans in 2014. Additionally, insurance companies still have the option of discontinuing the old, non-compliant plans and forcing all non-grandfathered individuals and small groups into the compliant plans on their 2014 anniversary date.

Regulations and Guidance

Amendment to Interim Final Rules
Amendment to the Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection and Affordable Care Act (11/17/2010)
CCIIO Fact Sheet on Amendment
Amendment to Regulation on “Grandfathered” Health Plans under the Affordable Care Act (11/17/2010)
Regulation
Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection and Affordable Care Act; Interim Final Rule and Proposed Rule )06/17/2010)
Provisions Summary Chart
This chart contains an illustrative summary of some of the new health reform provisions and does not cover all the specifics of the provisions. This chart provides an informal explanation of the new health reform provisions and should not be considered legal advice or interpretive guidance. (2010)
Model Notice | en español
To maintain status as a grandfathered health plan, a plan or health insurance coverage must include a statement, in any plan materials provided to a participant or beneficiary describing the benefits provided under the plan or health insurance coverage, that the plan or coverage believes it is a grandfathered health plan within the meaning of section 1251 of the Patient Protection and Affordable Care Act and must provide contact information for questions and complaints. This model language can be used to satisfy this disclosure requirement. (2010)

Video

Video: 36 Times Obama Said You Could Keep Your Health Care Plan

Posted 11/05/201 by Washington Free Beacon


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