The Grand Scheme of Grandfather Status

grandfathered business insurance

The Grand Scheme of Grandfather Status

On March 23rd, 2010, the Affordable Care Act was signed into law. This gave American families and businesses more control over their health care by providing great benefits and protections for family members and employees. During the health reform debate, President Obama made it clear to Americans that they could keep their health plan if they liked it. There was nothing in the new law that would force them to change plans or doctors. Those that chose to keep their plan have a status known as grandfathered status.

Depending on if you have grandfathered or non-grandfathered status affects the type of benefits that you receive. Grandfathered plans are health plans that were already in place before March 23rd, 2010: the day that the Affordable Care Act was signed into law. A grandfathered status plan might not include certain benefits or consumer protections that non-grandfathered plans are required to include such as:

    • They are not required to cover all preventive services at a $0 copay
    • They are not required to cover all of the benefits healthcare reform has deemed to be essential.
    • They have different member appeal rights.

When you have coverage through your employer, they make the decisions about what type of health coverage is available. Your employer also chooses whether your plan keeps its grandfathered status. As long as your employer maintains the grandfathered status plan, your benefits will remain generally unchanged. In addition, your benefits may not be the same as someone in a non-grandfathered status plan. Employees must be notified by either their employer or the insurer that their plan will be grandfathered. Small employers faced more significant rate increases and were more likely to give up their grandfathered status than large employers.

Originally, an employer could lose its grandfathered insurance plans status by switching from one insurance company to another. In November of 2010, an amendment allowed all group health plans to switch insurance companies and shop for the same coverage at a lower cost and maintain their grandfathered status. Our experts at AWS Insurance know that it can be confusing to figure out which health insurance plan best suits your needs. We will look at your options and decide what health insurance benefits are best for you, your family or your employees. Regardless of if you have grandfathered insurance plans or not, we will make sure you can have the best insurance for the best price.

Learn more about grandfathered health care plans here

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Melinda Martin

Account Executive

Melinda began her insurance career in 1985 with Alexander & Alexander where she received her Property & Casualty and Life & Health license. Since then she has worked at various agencies in the New Orleans area and in California as a senior account manager for Employee Benefit Plans.  While in California, she was also the Membership Director for the Burbank Chamber of Commerce. Melinda joined the AWS team in July of 2015.

Michael A. Seeling

Vice President

Graduated from the University of Louisiana at Lafayette with a B.A. in Insurance Risk Management and is a graduate of Archbishop Rummel High School in New Orleans. He joined AWS in October of 2008 and has been awarded the Patient Protection and Affordable Care Act Certification (PPACA). Additionally, he is working towards his Certified Insurance Counselor (CIC), Registered Health Underwriter (RHU), and Registered Employee Benefits Consultant (REBC) designations. He is also a member of the National Association of Health Underwriters (NAHU), National Association of Insurance Financial Advisors (NAIFA), and is an active member of the Fore!Kids foundation.

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