Grandfathered Plans

Last updated: March 30, 2016

Common Questions About Granddathered Plans

What Is a “Grandfathered” Health Plan?

A grandfathered health plan is a plan that has existed continuously since before March 23, 2010 (without significant changes in the plan).

  • Grandfathered plans aren’t subject to many of the requirements of the Affordable Care Act (ACA):

Grandfathered plans that make certain changes may lose their grandfathered status and then would have to follow the ACA. Changes such as:

  • Significant increases in their cost-sharing

    • (such as coinsurance, deductibles, copayments)  

  • Or eliminating benefits to diagnose or treat a particular condition

  • Employer-sponsored plans that substantially raise the employee share of the premium could also lose grandfathered status.

A plans must say in the plan material if it is a grandfathered plan.

Also, you can check with your insurance company or employer.

My Plan Is Not Grandfathered, But It Does Not Comply With the ACA’s Requirements. Can I Still Keep it?

In November 2013, the Obama Administration announced a transitional policy. This policy permitted certain policyholders to keep their 2013 coverage for another year (if the plan did not comply with certain ACA reforms).

In March 2014, the Administration extended this transitional policy. It allows the renewal of these plans for policy years that begin up to October 1, 2016.

  • These transitional plans may not be sold as new plans. They may only be sold as renewals.

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