§18011 Preservation of Right to Maintain Existing Coverage

Summary

If you were enrolled in a group health plan or health insurance on March 23, 2010, you do not have to drop that coverage because of the changes made by the law. Most new rules in subtitles A and this subtitle do not apply to those plans, even if the plan is renewed after March 23, 2010. Some specific protections do still apply to these "grandfathered health plans." Sections 2715 and 2718 apply for plan years starting on or after March 23, 2010. Other rules — including limits on waiting periods (2708), rules about lifetime limits (parts of 2711), rescissions (2712), and extending dependent coverage (2714) — apply when they would normally take effect. Annual limit rules and pre-existing condition rules (parts of 2711 and 2704) apply to group grandfathered plans when they would normally take effect. For plan years before January 1, 2014, the dependent coverage rule (2714) covers an adult child only if that child cannot enroll in another employer plan as defined in 26 U.S.C. 5000A(f)(2). Sections 300gg–111, 300gg–112, and 300gg–117 apply to these plans for plan years starting on or after January 1, 2022. Family members may enroll if the plan allowed it on March 23, 2010. Plans that add new employees (and their families) can keep being treated as grandfathered. Plans under collective bargaining agreements ratified before March 23, 2010 remain exempt until the last agreement ends; changes made only to follow these requirements do not end the bargaining agreement. "Grandfathered health plan" means any group health plan or insurance the rules above cover.