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Agencies Request Information on Easing Grandfathered Plan Burdens

On February 25, 2019, the Internal Revenue Service, Department of the Treasury, Employee Benefits Security Administration, Department of Labor, Centers for Medicare & Medicaid Services, and Department of Health and Human Services issued a Request for Information Regarding Grandfathered Group Health Plans and Grandfathered Group Health Insurance Coverage.

The request for information cites Executive Order 13765’s directive to minimize the burdens of the Affordable Care Act (ACA) as the reasoning for its quest to determine what are the burdens of maintaining grandfathered status and are there opportunities for the Departments to assist plans in preserving grandfathered status in ways that would benefit employers, employee organizations, plan participants, beneficiaries, and other stakeholders.

Information sought by the agencies includes, but is not limited to:

  • How could the Departments assist in maintaining grandfathered status?
  • Do certain requirements make maintaining grandfathered status more challenging?
  • Why are you maintaining grandfathered status? To avoid what requirements?
  • Why have individuals remained enrolled in the grandfathered plan with other options available?
  • What factors do you consider in choosing whether to retain grandfathered status?
  • Is maintaining grandfathered status important to plan participants? Why?
  • What are the typical changes that cause the loss of grandfathered status?
  • Do the grandfathered plan disclosure requirements provide adequate information?
  • What resources are available to determine the number of grandfathered plans/participants?
  • What are the characteristics of grandfathered plans? Size, location, industry?
  • What are the typical differences between grandfathered plans and non-grandfathered plans?
  • How many plans are considering making changes that would lose grandfathered status?

For any employer that has been maintaining grandfathered status, over the years it has been difficult to maintain applicable benchmarks and adhere to budgetary constraints without causing the loss of grandfathered status.

This request for information provides an opportunity for those employers and others to provide input that could ease the burden of maintaining grandfathered status.

Comments are due within 30 days of publication of the request for information. You can submit comments electronically at or by mail to:

Centers for Medicare & Medicaid Services, Dept. of Health and Human Services,
Attn: CMS-9923-NC,
P.O. Box 8013,
Baltimore, MD 21244-1850

For clarification on your company’s status or the request for information, contact your OneDigital consultant today.