Health Care Reform

Grandfathered Provisions

Grandfathered status is available for a health plan that was providing coverage as of March 23, 2010 and has not been changed in any impermissible way (as detailed by federal regulations) since then. Grandfathering is available for some of the new market reform provisions, which were added to HIPAA. A high level summary of those requirements is included below. Grandfathering is not available for other ACA requirements, such as the Free Rider Penalty, changes to health FSAs and HSAs, etc. Note that HIPAA Exceptied Benefits are exempt from the requirements below – click here to learn more.

* 2010 requirements take effect the first plan year beginning on or after September 23, 2010.  2014 requirements take effect the first plan year beginning on or after January 1, 2014.


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