CMS Grandfathers Individual and Small Health Plans

///CMS Grandfathers Individual and Small Health Plans

CMS Grandfathers Individual and Small Health Plans

The Centers for Medicare and Medicaid Services released a guidance Thursday that will permit individual and small health plans that are not ACA-compliant to function until December 31, 2018.

The Trump Administration has taken this step in an effort to stabilize the individual insurance market, but critics believe this can hurt the attempts to stabilize the market. Experts say this action will affect the market because healthier people will be staying in plans that are outside of the ACA-regulated groups.

The number of people that will stay in the grandfathered plans will be less than one million people across about 36 states. 

The non-ACA compliant plans are permitted to:

  • Charge more based on gender or a pre-existing medical condition
  • They do not need to meet guaranteed renewability standards
  • They don’t need to cover essential health benefits (ex:prescription drugs)
  • They don’t need to limit out-of-pocket spending for the year
  • They don’t need to meet standards for participation in clinical trials

Read the original article from Modern Healthcare here.

By | 2017-02-24T10:43:13+00:00 February 24th, 2017|Articles, Industry Updates|0 Comments