Health Care Reform: Grandfathering

A health plan in existence on March 23, 2010 may be eligible for "grandfathered" status. Changes in benefits or other plan terms may result in the loss of that status. Many of the requirements of health care reform will apply to your plan whether or not you maintain grandfathered status.
All plans will have the following changes:
•Elimination of lifetime limits on essential benefits
•Phase-out of annual limits on essential benefits by 2014
•Eligibility for dependents up to age 26
•Elimination of pre-existing limitations for children under 19
•Elimination of all pre-existing limitations by 2014
•Limitation of benefit waiting periods to 90 days or less
Grandfathered plans will not have these requirements:
•Choice between PCPs and Pediatricians
•Direct access (no referral) to OB/GYN
•Covered emergency services without referral
•Preventive care and immunizations without cost sharing
•Essential benefits in 2014
•Cost share and deductible limits in 2014
Note that nearly all plans comply with the first three points.
Most health plans will not remain grandfathered. These plans will be subject to severe on-going restrictions on future benefit changes. Many carriers have announced that they will not be offering grandfathered plans.