Will Senator Ted Cruz Come To The Rescue?

Frustrated by a lack of response to our previous inquiries among numerous sources we approached (including several well known benefit experts) in seeking a definitive answer to a burning ACA question we have, it was decided by staff to attempt one last hopeful effort in peeling back the regulatory onion in search of the truth. Will Ted and his staff come to the rescue?

Letter Sent Snail Mail to Hon. Ted Cruz, U.S. Senator 20 June, 2019:

RE: Question Regarding Grandfather Status – Affordable Care Act

Dear Senator Cruz,

I have a question regarding maintaining grandfather status under the Affordable Care Act (ACA) and hope your office can assist me.

Under the Affordable Care Act (ACA) a plan which is grandfathered may increase benefits and still maintain grandfather status. What is unclear is whether a plan can continue to maintain grandfather status if they increase benefits one year and subsequently reduce those benefits back to the original level as were in effect when the group was grandfathered.

It is my understanding that to maintain grandfathered status, a plan must look at its benefits and contribution levels as of March 23, 2010 as the benchmark. If taken at face value and true, the answer to the question below is “yes.” However, I can find no definitive documentation to support this.

QUESTION: In the scenario described above (increase benefits then subsequently restore previous benefits) will a plan maintain grandfather status?

 

 

 

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