What provisions of the new law apply to a grandfathered plan?
Even a grandfathered plan (effective as of the first day of the plan year beginning on or after September 23, 2010) must provide extended dependent coverage to children up to age 26, refrain from rescinding coverage, eliminate lifetime dollar value limits on essential benefits and pre-existing condition exclusions for children under age 19, and restrict annual limits on essential benefits in accordance with regulations (yet to be issued). Additionally, in the next couple of years, a grandfathered plan must provide uniform explanations of coverage, eliminate entirely annual limits on essential benefits and pre-existing condition exclusions, and eliminate waiting periods in excess of 90 days. The DOL’s table (http://www.dol.gov/ebsa/pdf/grandfatherregtable.pdf) also lists the provisions that apply to grandfathered plans. Is a grandfathered plan exempt from the new law’s employer “pay or play” penalty? No, a grandfathered health plan is subject to the pay-or-play penalty provisions of the
