New Health Care Act Implementation: Keeping What You Have

Although health care reform became law on March 23, insurance plans in effect at the time can maintain their old status, with a few exceptions, under a "grandfathering" provision in the law.

The grandfathering provision, which will probably benefit most plans, applies to individual, group, fully insured and self-insured plans.

Certain new requirements apply to all plans, including those in effect on March 23, and must be implemented before January 2011. Those include:

• No lifetime limits on coverage.
• No rescission of coverage because of illness.
• Extension of coverage to children under age 27.

For those covered by employer-based group plans, there are some additional required changes:

• No exclusions from coverage of children under 19 because of pre-existing conditions.
• No restricted annual limits.

There had been speculation as to what changes could be made in grandfathered plans without threatening the grandfathered status.

On June 14, the Department of Health and Human Services issued new guidelines on the subject, which should help individuals and businesses decide how they want to address their existing plans.

More information on these required changes for grandfathered plans should be coming out steadily.

Insureds should not hesitate to call their insurance companies or their employers (if in a group plan) for more information.

Alan Wenger can be reached at awenger@hhmlaw.com or at (330) 744-1111.