FrediFredo
10-30-2011, 03:07 PM
Based on the readings, grandfathered plans remain free from a number of the significant reforms found in PPACA:
1. The requirement that individual and small group plans cover “essential health benefit” beginning in 2014.
2. Cover preventive services without cost-sharing;
3. Do not discriminate in favor of highly compensated individuals;
4. Report on their quality of care improvement activities ;
5. Provide their enrollees internal and external appeal procedures against claims denials (although it already exists with ERISA)
6. Provide unimpeded access to emergency, pediatric, obstetric, and gynecological care.
However, on the internet, I read interesting things like:
1. Permissible changes which will not impact the grandfathered status
2. Impermissible Changes which will Cause the Loss of Grandfather Status
I am not sure i've seen such information in the syllabus readings regarding this. As anyone did?
1. The requirement that individual and small group plans cover “essential health benefit” beginning in 2014.
2. Cover preventive services without cost-sharing;
3. Do not discriminate in favor of highly compensated individuals;
4. Report on their quality of care improvement activities ;
5. Provide their enrollees internal and external appeal procedures against claims denials (although it already exists with ERISA)
6. Provide unimpeded access to emergency, pediatric, obstetric, and gynecological care.
However, on the internet, I read interesting things like:
1. Permissible changes which will not impact the grandfathered status
2. Impermissible Changes which will Cause the Loss of Grandfather Status
I am not sure i've seen such information in the syllabus readings regarding this. As anyone did?