The Departments of Health and Human Services (HHS), Labor, and Treasury
Nov. 17 issued an amendment to the
June 17 interim final rules on grandfathered health plans. The amendment permits certain changes in policies, certificates, or contracts of insurance without loss of grandfather status.
Under the Patient Protection and Affordable Care Act (PPACA), grandfathered health plans are defined as certain plans and insurance coverage that existed on March 23, 2010. Grandfathered plans are required to comply with some but not all of the health reforms contained in PPACA.
The June 17 interim final rules specify
certain changes to a plan or coverage that would cause it to lose its grandfathered status, such as a group health plan changing issuers. However, a self-insured group health plan could change a third party administrator without losing its status as a grandfathered health plan, so long as it did not make any other changes that would revoke its status.
After reviewing public comments, the departments decided to amend the interim final regulations to allow a group health plan to change health insurance coverage (that is, to allow a group health plan to enter into a new policy, certificate, or contract of insurance) without ceasing to be a grandfathered plan, provided that no other changes are made that would cause the plan to lose grandfathered status. The amendment became effective Nov. 15 and does not apply retroactively to such changes to group health insurance coverage that were effective before Nov. 15. According to the amendment, the date the new coverage becomes effective is the operative date, not the date a contract for a new policy, certificate, or contract of insurance is entered into.
Group health plans are affected by the amendment. However, a change of issuers in the individual market would still result in the loss of grandfathered status.
Comments are due on or before Dec. 17. To file comments, visit
http://www.regulations.gov/search/Regs/home.html#documentDetail?R=0900006480b9545b.
For more information about grandfathered health plans use the following resources:
Nov. 17 fact sheet
Comments submitted by ABC and Newsline article Frequently Asked Questions Department of Labor