HR pop quiz: How can a health plan lose grandfathered status?

Health and Human Services Secretary Kathleen Sebelius gestures during a news conference on Capitol Hill in Washington Thursday, Sept. 23, 2010 (AP Photo/Alex Brandon) Health and Human Services Secretary Kathleen Sebelius gestures during a news conference on Capitol Hill in Washington Thursday, Sept. 23, 2010 (AP Photo/Alex Brandon)

For policies in effect on or before March 23, 2010, which of the following changes would cause a health care plan to lose its grandfathered status?

Answer:

A) Adding new benefits

B) Lowering employer contribution by 10%

C) Increasing premiums

D) Decreasing co-insurance charges

E) Voluntarily adopting new consumer protections

A) Adding new benefits

Incorrect. Try again!

B) Lowering employer contribution by 10%

Correct!

Grandfathered health plans can make routine changes including:

  • cost adjustments to keep pace with medical inflation;
  • adding new benefits;
  •  making modest adjustments to existing benefits;
  • voluntarily adopting new consumer protections under the new law; or
  • making changes to comply with State or other Federal laws. 

Furthermore, premium changes are not taken into account when determining whether or not a plan is grandfathered.  However, decreasing or lowering the percent of premiums the employer pays by more than 5 percentage points and increasing (vs. decreasing in the choices above) co-insurance charges are changes that would cause a plan to lose its grandfathered status.

C) Increasing premiums

Incorrect. Try again!

D) Decreasing co-insurance charges

Incorrect. Try again!

E) Voluntarily adopting new consumer protections

Incorrect. Try again!

 

 

 

 

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