A Look at the Affordable Care Act: Grandfathered Plans

A Look at the Affordable Care Act: Grandfathered Plans Each month AssuredPartners NL will discuss a different aspect of the Affordable Care Act. Stay tuned for more updates on the second Thursday of each month. Click here for more Affordable Care Act blogs.    

As 2014 quickly approaches, many of the reforms outlined by the Affordable Care Act in 2010 are now underway. One important reform is the grandfathering of some health insurance plans. The Affordable Care Act exempts some grandfathered health plans from some of the law’s consumer protections.

But how do you know if your health insurance plan qualifies for grandfathered status? If you have health coverage from a plan existing before March 23, 2010, and that plan has covered at least one person continuously since March 23, 2010, your plan might be considered a grandfathered plan.

To determine if your plan qualifies for grandfathered status, follow these steps, from Zywave:

  • Review your plan’s materials. Beginning on or after Sept. 23, 2010, grandfathered health plans must disclose their status in any plan materials distributed to beneficiaries or subscribers. The material must also include contact information for questions.
  • Check with your employer or benefits administrator. If you are in a group health plan, the date you joined may not accurately reflect the date the plan was created. New employees and new family members can still be added to a grandfathered group health plan.

With the Affordable Care Act, Americans can keep their current health benefits—the law will not force a change in plans or doctors. However, the Affordable Care Act does stipulate that all plans, including grandfathered plans, must meet certain requirements, including:

  • No lifetime limits on coverage to key health benefits
  • No cancellation of coverage, except in access of fraud or misrepresentation
  • Extension of dependent coverage to young adults up to age 26

Will you be keeping your grandfathered health insurance plan, or are you looking to make a change? Our team of dedicated employee benefits specialist can review your existing coverage and discuss new options with you. For questions about the Affordable Care Act, contact a AssuredPartners NL representative. Be sure to check back on the second Thursday of each month as we discuss the Affordable Care Act and what it means to you.

This post is not intended to be exhaustive, nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.

*Information from Zywave

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