What are the differences between grandfathered plans, non-grandfathered plans, and new plans under the Affordable Care Act (ACA)?
Here is a helpful chart with some of the key points.
| Grandfathered Plans (purchased before 3/23/2010 and still active) | Non-Grandfathered Plans (purchased 3/23/2010 or later and active prior to 1/1/14) | New Plans Effective in 2014 | |
| Annual Coverage Limits | Annual dollar limits on coverage are ok | Not allowed | Not allowed |
| Lifetime Coverage Limits | Not allowed | Not allowed | Not allowed |
| Cost-sharing for preventative services (i.e., patient must pay for portion of service) | Allowed | Not allowed | Not allowed |
| Pricing | Based on an individual’s health status | Based on an individual’s health status | NOT based on an individual’s health |
| Guaranteed Issue | Not required | Not required | Required |
| Coverage for 10 Essential Health Benefits | Not required | Not required | Required |
| Actuarial Value – plan must cover at least 60% of average annual cost per customer | Not required | Not required | Required |
| Children up to age 26 can be covered under a parent’s plan | Required | Required | Required |
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