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Health care reform and grandfathered plans

Monday, July 12, 2010
Written By
Erica Storm

“Can I keep my health insurance coverage?” was a common question during the health care reform debate – people all over the country were concerned that a new law would mean drastic changes to, or even complete elimination of, their coverage.

However, the health care reform law specifically says that people don’t have to terminate their coverage. To motivate employers to keep their plans in place, the law includes incentives for “grandfathered plans.” If a plan was in existence on March 23, 2010, it gets a pass on a number of health care reform requirements, like providing first dollar coverage for preventive care and other consumer protections.

Let’s face it – clients are always happy when you tell them they DON’T have to comply with a rule. One less thing to worry about it. But no one really knew what you had to do to remain grandfathered. Finally in June, regulations were issued that give us guidance on what changes can be made to grandfathered plans.

Unfortunately, these rules were more restrictive than we might have hoped. It seems as though it will be pretty tough for a lot of plans to retain that grandfathered status. In light of these developments, there are a few things you can do for your clients:

  • Don’t panic. Although grandfathered status may be difficult to keep, the consequences of losing it will depend on each plan’s design. Some of the new requirements may not be all that burdensome for some plans.
  • Learn about the rules. There is a lot of information out there and it may be overwhelming your clients. If you can sift through some of it and be a knowledgeable resource, your clients will appreciate being able to count on you.
  • Explore your options. There is some transition relief available under the regs. Some changes may be disregarded and others your clients may be able to take back. Make sure you know what’s out there.

For resources, log in to Broker Briefcase BE. The legal and content teams are working to help you stay one step ahead in servicing your clients’ health care reform needs.

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