2017 Health Care Reform Checklist
This checklist is designed to help employers who sponsor group health plans review their compliance with key provisions of the Affordable Care Act
(ACA). If you have any questions regarding your responsibilities,
please contact a knowledgeable employment law attorney, benefits
advisor, or your carrier.
Please Note: This list is
for general reference purposes only and is not all-inclusive. The
information is subject to change based on new requirements or amendments
to the law. Additionally, your company or group health plan may be
exempt from certain requirements and/or subject to more stringent rules
under your state's laws.
1. Evaluate Grandfathered Status of Group Health Plan
A grandfathered plan is one in
existence as of March 23, 2010 that has covered at least one person
continuously from that day forward. Grandfathered plans do not have to comply with certain ACA rules.
- Determine whether any changes to the plan that reduce benefits or
increase costs to employees and dependents enrolled in coverage result
in a loss of grandfathered status.
- If the plan loses grandfathered status, confirm that the plan design and benefits offered reflect all ACA requirements that previously did not apply because the plan was exempt (such as coverage of preventive services without cost-sharing).
- If the plan remains grandfathered, provide a Notice of Grandfathered Status
whenever a summary of plan benefits is provided to participants and
beneficiaries. Continue to maintain records documenting the terms of the
plan that were in effect on March 23, 2010, and any other documents
necessary to verify grandfathered status.
2. Review Plan Documents for Required Changes to Plan Benefits