Questions to ask that could cause a plan to lose grandfathering
Questions to ask that could cause a plan to lose grandfathering

If you change to a different plan, but with the same Insurance Company and the same rules in your Employee Handbook, is the plan still grandfathered?

***Grandfathering means that if your coverage was in place on 9.23.2010, when the Affordable Care Act was enacted, President Obama promised that you could keep it, as long as there were no “major” changes to you coverage.  See 8 Questions to see.   Learn More


We have, per our [Employee] Handbook, carved out a [Management] carve outs, class of covered employees.  this has been in force well before 2010

We are a small business,  less than 10 employees

the covered employees have always been just 2.  One of the employees recently went into medicare.  since needed 2 employees to make a group

***That’s not exactly correct, see §10753  (q) (1) “Small employer”

we converted to an individual plan for the remaining employee.  The plan stayed with the same insurance co. but not in our companies name.

So, would this still be be considered “grandfathered?

***No.  Sounds like major changes to me.   Check this links for details about cutting or lowering coverage, coinsurance, payments, deductibles, employer contributions, annual limits.  *   *    Our Page on Grandfathering   *   HN Flyer

While it doesn’t appear that Salary Discrimination under Section 2716 is being enforced, you can’t call an Individual Plan a Group plan, nor can your company take the deduction under IRC Section 106!


Related Pages in Grand Fathered Plans Section

Blue Shield

Blue Shield Grandfathering WebPage   FAQ     4.1.2015 one time 25% credit on monthly bill

Blue Cross


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