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Collectively Bargained Plans

Timeline of Provisions

Collectively Bargained Plans

Provisions effective 2010

Summary

For health insurance coverage maintained pursuant to one or more collective bargaining agreements (CBAs) ratified before March 23, 2010, many key provisions of the health reform law do not apply until the date on which the last of the collective bargaining agreements relating to the coverage terminates.

There are special rules for health insurance coverage maintained pursuant to one or more collective bargaining agreements ratified before March 23, 2010. Coverage will remain grandfathered at least until the date on which the last agreement relating to the coverage that was in effect on March 23, 2010 terminates. The Interim Final Rule (IFR) clarifies that the collectively bargained exception to grandfather status applies only to insured collectively bargained plans – not self-funded collectively bargained plans.

Frequently Asked Questions

Will a fully insured collectively bargained plan maintain grandfather status when switching insurers?

Yes.

When an exempt CBA plan loses its exempt status because the last of the CBAs terminates, is the plan subject to the general grandfather exemption?

When the last of the collective bargaining agreements terminates, the comparison of the current plan will be matched up to the terms of the coverage that were in effect on March 23, 2010, to determine if the plan is still grandfathered.

Which provisions of the reform law are insured CBA plans exempt from?

Insured CBA plans are exempt from all of the requirements in Subtitles A and C for the duration of the exemption. Subtitles A and C include all of the requirements and prohibitions described in the Grandfathered Plans section. In other words, none of these mandates will apply to a CBA plan under the exemption until the last of the CBAs terminates. However, these grandfathered plans are not provided with a delayed effective date for the market reform provisions with which other grandfathered health plans must comply (e.g., adult dependent coverage to age 26, restricted annual limits on Essential Health Benefits). Thus, these provisions apply to collectively bargained plans before and after termination of the last of the applicable collective bargaining agreement.

Uncertainties

None noted.