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Feds Wonder If Grandfathered Group Health Plans Need Help

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Three federal agencies want to know what kind of care they need to provide for the group major medical insurance arrangements that have been in place since before March 23, 2010.

The “tri agencies” — the Internal Revenue Service, the Employee Benefits Securities Administration and the Centers for Medicare and Medicaid Services — are putting out an official request for information about “grandfathered” group plans.

(Related: CMS Lets ‘Grandmothered’ Plans Live Another Year)

Grandfathered plans are group major medical plans that have been in effect since before former President Barack Obama signed the Affordable Care Act statutory package into law.

The tri-agencies say they believe that only a small number of people still have grandfathered individual major medical policies, but that about 16% of the workers who had group health coverage in 2018 were still enrolled in a grandfathered plan.

The agencies are asking members of the public for grandfathered plan data, and for ideas about how they can help group health plans keep their grandfathered status intact.

“What challenges do group health plan sponsors and group health insurance issuers face regarding retaining the grandfathered status of a plan or coverage?” the agencies ask. “Does any particular requirement(s) for maintaining grandfathered status create more challenges than others, and if so, how could the requirement(s) be modified to reduce such challenges?”

The agencies also ask sponsors and insurers why they have chosen to keep grandfathered status, and why some workers who have a choice between grandfathered plans and non-grandfathered plans have stuck with the grandfathered plans.

Responses to the request for information are due March 27.


A copy of the federal agencies’ request for information is available here.

The contact people listed are William Fischer, for the IRS; Matthew Litton and David Sydlik, for EBSA; and Kiahana Brooks, for CMS.

— Read ACA: New HHS Health Agency Helps Issue Grandfather Regson ThinkAdvisor.

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