Which immediate reforms in the health reform law apply to grandfathered plans?
All plans, including grandfathered plans, must provide new, standardized coverage information to consumers, eliminate any limits on the amount that a plan will pay out over an enrollee’s lifetime, and make coverage available to dependents up to age 26. Plans also must provide rebates to enrollees when the plans fail to spend at least a specified percentage of premiums collected on the actual provision of health care and efforts to improve health care quality. And the law prohibits plans, including grandfathered plans, from arbitrarily revoking coverage after a beneficiary gets sick. In addition, grandfathered employer plans (those provided by both small and large businesses) must abide by new restrictions on annual benefit limits and must provide coverage for children’s pre-existing medical conditions. These two requirements do not apply to grandfathered plans in the individual market.
