Under the ACA, certain group health plans and health insurance coverage existing as of March 23, 2010 (the date of enactment of the ACA), are considered “grandfathered” and excused from complying with some of the ACA’s health care improvement and market reform provisions. On June 17, 2010, the Department of Health and Human Services (HHS) and the Departments of Labor and Treasury published interim final rules on the "Status as a Grandfathered Health Plan under the Patient Protection and Affordable Care Act." Among other things, the rule establishes the circumstances under which plan sponsors may adjust co-payments, deductibles and employer contributions to their employees' premiums without forfeiting their grandfather status. For instance, as described in greater detail in the regulation, grandfathered plans may adjust costs to keep pace with medical inflation, add new benefits, make modest adjustments to existing benefits, voluntarily adopt certain new consumer protections, or make changes to comply with state or other federal laws. Plans will lose their grandfathered status, however, if they make major changes, such as significantly cutting or reducing benefits; significantly raising coinsurance, copayments, or deductibles; significantly lowering employer contributions or caps on payments for covered services; or changing insurance companies (with certain exceptions). The interim final rule is effective June 14, 2010, with certain exceptions, and comments will be accepted until August 16, 2010. HHS has posted a fact sheet summarizing the grandfathered health plan rule.
Trackbacks (0) Links to blogs that reference this article Trackback URL