grandmothered health plan

What is a grandmothered health plan?

Grandmothered plans are individual and small-group health plans that took effect after the Affordable Care Act was signed into law in March 2010, but before the exchanges opened for business in October 2013. (In some states, grandmothered plans include plans that were issued as late as the end of 2013.)
Initially, the plan was for these policies to be discontinued at the end of 2013, or at their renewal date in 2014, since they were not grandfathered (in effect at the time the ACA was enacted). But the ensuing uproar over plan cancellation notifications in the fall of 2013 resulted in the Obama Administration implementing a “keep your plan” fix that allowed people to keep their non-grandfathered, non-ACA-compliant plans throughout 2014.
That “keep your plan” provision has subsequently been extended each year, most recently in 2020. Grandmothered plans can remain in force until the end of 2021, as long as the state and the insurer permit it (the federal extension ultimately leaves the decision up to each state — some states have cut off grandmothered plans or never allowed them in the first place, while other states still have grandmothered plans that will remain in effect throughout 2021).
Grandmothered plans do not have to comply with the bulk of the ACA’s provisions, but they cannot have annual or lifetime benefit limits for essential health benefits that they cover (although they are not required to cover essential health benefits other than preventive care).
Grandmothered plans have not been available for purchase by any individuals or employers since the end of 2013, but employees can still newly enroll in grandmothered plans, as long as the employer purchased the plan prior to 2014 (small group grandmothered plans cannot impose pre-existing condition exclusions, or benefit waiting periods that exceed 90 days).
Note that grandmothered plans are not the same as grandfathered plans.

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