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Final regulations: Grandfathered group health plans, health insurance coverage

Grandfathered group health plans, health insurance

The U.S. Treasury Department and IRS, along with the Labor Department and Department of Health and Human Services, today jointly released for publication in the Federal Register final regulations (T.D. 9928) regarding grandfathered group health plans and grandfathered group health insurance coverage.


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The final regulations amend current rules “to provide greater flexibility for certain grandfathered health plans to make changes to certain types of fixed amount cost-sharing requirements without causing a loss of grandfather status under the Patient Protection and Affordable Care Act.”

Read the final regulations [PDF 395 KB] (26 pages as published in the Federal Register on December 15, 2020)

Regulations were proposed in July 2020 to amend the 2015 final rules to provide greater flexibility for grandfathered group health plans and issuers of grandfathered group health insurance coverage to make certain changes without causing a loss of grandfather status. Those proposed regulations included changes to:

  • Enable eligible plans to continue offering affordable coverage while also enhancing their ability to respond to rising healthcare costs
  • Permit group health plans to increase cost-sharing requirements for enrolled individuals as long as they do not exceed certain limits
  • Allow, in some situations, plans to comply with minimum cost-sharing requirements for high deductible health plans (HDHPs) so enrolled individuals are eligible to contribute to health savings accounts (HSAs)

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The preamble to today’s final regulations states they “finalize the 2020 proposed rules without substantive change.”

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