Will Your 2011 Health Plan Compromise Grandfathered Status?

Thursday, August 5, 2010 by Andy Kuhn

Many employers are in the midst of planning for 2011.  When looking over operating costs, one area of concern is the expense of offering employee benefits insurance.  With the continued uncertainty in the economy and the mounting changes from healthcare reform, it can be a lot to consider. 

Many employers want to know what changes will cause them to lose "Grandfathered" Status.  As outlined in a previous blog, any change in insurance carriers or significant increases to existing plans will compromise your status. 

Here are a couple of key elements for any plan that existed March 23, 2010.  You will want to make note of the following dis-qualifiers: 
  • Co-payments.  A greater increase of $5 or an increase higher than medical inflation plus 15 percentage points.
  • Deductibles.   An increase above medical inflation plus 15 percentage points.
  • Co-insurance. Any increase in the rate after March 23, 2010.
  • Out-of-Pocket Limit. An increase above medical inflation plus 15 percentage points.
  • Annual Limit.  Any decreases in annual limit that was in place on March 23, 2010 or adoption of one that did not exist at that time. Exception is if lifetime limits may be replaced with a annual one.
  • Employer Contributions. A decrease of more than 5 percentage points below the existing employer rate.
For an in-depth list see the interim final rule on grandfathered plans.  To ensure that you maintain compliance with existing and future regulations, consider employing the services of a Small Business PEO.  Management 2000 provides Human Resources Outsourcing Service and Employee Benefits Administration.  We will welcome the opportunity to manage your employee benefits, so you can run a business.

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