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.

Alta Vista Benefits August 2009 Newsletter

Issue #16

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.

Health Care Reform: What You Can Do

Health Care Reform is an extremely important issue for all Americans and there is pressure on Congress to come up with a solution by the end of 2009. To meet this goal, Congress continues to work on several versions of health care legislation. However, the August recess is coming up, so it is unlikely that any legislation will be brought to the floor right now.

During the recess, many of the legislators will be in their home states holding Town Hall meetings and meeting with constituents. This recess is a critical time for all of us to weigh in with our legislators in the House and Senate to ensure that the final bill is what we all want.

As a consumer advocate for health care, Alta Vista Benefits wants to make sure that you have timely information about the proposed legislation. The link for the House Bill for Health Care Reform is the actual HR3200 House bill.

Even if you don't read the entire document, there a several sections that are worth reading. Page 50 defines that health care and health insurance will be available to everyone, regardless of citizenship. Pages 58 and 59 gives the Federal Government the right to access all of our personal financial information, including the right to do electronic transfers. Page 253 gives the Federal Government the right to assess a doctor's judgment and skills to determine his billing value.

Please take the opportunity to read House Bill 3200, evaluate it yourself and let your representatives know what you want.

Did You Know?

The limits for HSA contributions are changing for 2010. An individual will be able to contribute $3,050 in 2010 and the family limit will be $6,150.

Long term care premiums can be paid out of an HSA and deducted. If you would like to know more about HSA accounts, please contact us at 614-889-0934.