Keeping the Health Plan You Have - Grandfathering under the Affordable Care Act

Issue #21


The monthly Alta Vista Benefits newsletter is provided as a service to help with issues in your every day life. Your suggestions and feedback can be e-mailed to lucy@altavistaben.com.

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Keeping the Health Plan You Have

Grandfathering under the Affordable Care Act



The Department of Health and Human Services today announced the provisions of the Affordable Care Act that affect "grandfathering" status for Americans who currently have health plans. These provisions affect individuals who purchase their own health insurance as well as individuals who have employer-sponsored health coverage.

The new provisions allow plans that existed on March 23, 2010 to make routine changes without losing grandfather status. The routine changes include:
* Cost adjustments to keep pace with medical inflation;
* Adding new benefits;
* Making modest adjustments to existing benefits; and
* Adopting new consumer protections or making changes to comply with Federal or state laws.

Premium changes are not used when determining whether or not a plan is grandfathered. However, changing insurance companies will cause a loss of grandfathered status.

If a health plan loses its grandfathered status, consumers will gain new benefits, including:
* Coverage of recommended prevention services with no cost sharing; and
* Patient protections such as guaranteed access to OB-GYNs and pediatricians.

All health plans regardless if they are grandfathered plans or not must provide certain benefits for plan years starting on or after September 23, 2010, including:

* No lifetime limits on coverage for all plans;
* No recissions of coverage when people get sick and have previously made an unintentional mistake on their application;
* Extension of parents’ coverage to adults under 26 years of age

For Americans who get their health insurance through employers, additional benefits will be offered, whether or not their plan is grandfathered, including:

* No coverage exclusions for children with pre-existing conditions; and
* No “restricted” annual limits

Alta Vista Benefits is committed to giving you information about the Affordable Care Act as quickly as it is made available. If you would like to know more, please contact us today.


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Did You Know?
Life Insurance

Life insurance can provide benefits to your family in addition to a death benefit. Many clients are using whole life policies as a way to save money for college educations, gift money to children and grandchildren or create a retirement fund.

For more information about how you can use life insurance as part of your financial strategy, please contact us.


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Lucy Grosz is the CEO of Alta Vista Benefits and can be reached at lucy@altavistaben.com or by phone at 614-889-0934.