PPACA: Grandfathers Can Shop Around

say in a preamble to the new amendment.

Some commenters noted that an insured employer would lose grandfathered status if it changed carriers, but a self-insured plan would not lose grandfathered status if it changed plan administrators, officials say.

Commenters said the golden ager handcuffs rule also could cause problems if a carrier stopped selling the employer’s policy, or if a carrier had administrative reasons to reissue an employer’s policy.

“Finally,” officials say, “commenters expressed concern that the provision terminating grandfather status upon any change in issuer gives issuers undue and unfair leverage in negotiating the price of coverage renewals with the sponsors of grandfathered health plans, and that this interferes with the health care cost containment that tends to result from price competition.”

To keep grandfathered status after switching carriers or policies, an employer must show the new carrier that the new plan will be similar enough to the old plan to qualify for grandfathered status, officials say.

The federal agencies intend to publish the amendment Wednesday in the Federal Register. Comments on the change will be due 30 days after the official publication date.

But, if an individual changes carriers and buys a similar policy, the new policy will still lose grandfathered status, officials say.