Grandfathering Introduction

Grandfathering means that if your coverage was in place on 9.23.2010, when the Affordable Care Act was enacted, President Obama promised that you could keep it,  see also USA Today as long as there were no “major” changes to your coverage.  

However, UNCovered CA, did NOT honor that!  Covered CA forced insurers to cancel policies!

8 questions to determine Grandfathered status 

Check out the Health Net Flyer below, where it explains that if health plans significantly raise co-payments or deductibles, or if they significantly reduce benefits – for example, if they stop covering treatment for a disease like HIV/AIDS or cystic fibrosis – they’ll lose their grandfathered status and their customers will get the same full set of consumer protections as new plans. ^{(healthreform.gov)}

Advantage of a Grandfathered Plan

The primary one  is that in 2014 the rating for the non grandfathered plans (ACA Obamacare) will be subject to additional taxes and fees. These could total upwards of 50% higher than a comparable grandfathered plans. Since the rates will be so much higher than the grandfathered plans we feel it would be a good idea to keep those plans until at least we see how the rates look like in 2014.^{Excerpt of Email Rec’d 1.25.2013 from a Major Insurance Company}

However, the

Government says NO

in Q & A on their website at healthreform.gov

• Individual Grandfathered plans are “closed” plans, no longer sold to new applicants. It is possible that premiums or costs may increase because new, healthy applicants are no longer being added to the closed “pool” of members. Premium changes for all plans, whether “closed” or open to new sales, are driven by several factors. These include increased consumer demand for services, rising prescription drug costs, advances in medical technology, and benefits and/or taxes required by state and federal legislation. ^{Blue Cross Flyer}

• make some changes to the benefits their plans offer,
• raise premiums or change employee cost-sharing to keep pace with health costs within some limits, and
• continue to enroll new employees and their families.

The bottom line is that under the Affordable Care Act, if you like your doctor and plan, you can keep them, subject to “Narrow Lists.”    But if you aren’t satisfied with your insurance options today, the Affordable Care Act provides for better, more affordable health care choices through new consumer protections.  ^{(healthreform.gov)}

Wikipedia on Health Reform & Grandfathering

No more RAF – Rating Adjustment Factor  §10753.14 in Employer Group Plans

Insurance Companies NOT offering Plans?
Thus the End of Grand Fathering?

• Blue Cross is dropping 79 plans.
• California Health Line 10.3.2014 reports Blue Cross, Kaiser and various other insurers are not renewing pre ACA plans, that don’t have the 10 essential benefits and other provisions of ACA.
• Reasoning – Washington Post?

FAQ’s

1. Which will be less expensive Grandfathered or Not?

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General Client  Resources & Links

• grand fathered-plans (health care.gov) web archive
• Press Release 6/25/2010

Research & Technical Links