Tip Tuesday! 5 sneaky ways your health plan could lose grandfathered status

by Jared Bilski

Employers that have managed to hang on to their grandfathered health plans for this long will want to pay close attention to the feds’ final regs on the subject. 

The trifecta of federal agencies (DOL, HHS and IRS) just released the final rules on grandfathered plan status under the ACA — as well as pre-existing conditions, exclusions, lifetime and annual limits, rescissions, claims and appeals, and dependent coverage.

Despite the length of these final rules (104 pages), there aren’t any wholesale changes that are likely to cause employers to overhaul their current compliance strategy. However, there are some important clarifications and tweaks.

Immediately loses, key exemptions

Here are some key highlights of the final regs:

One plan’s status change doesn’t change all benefits packages. While a plan’s grandfathered status is lost immediately when a prohibited plan change is made (even mid-year), that status loss applies separately to each different benefits package offered. In other words, the loss of grandfathered status for a PPO plan won’t impact the status of an HDHP option.

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