CMS Extends Non-Enforcement Policy Through 2021

The Centers for Medicare and Medicaid Services have once again extended the non-enforcement policy regarding individual and small group grandmothered health coverage that does not meet certain compliance guidelines currently enforced by the Affordable Car Act. The extension applies for plans that will begin on or before October 1, 2021, with the intention that by January 1, 2022, grandmothered coverage will be fully compliant with the ACA.

 Grandfathered Plans are not affected by the Non-Enforcement policy and will continue to be exempt from ACA compliance regulations.

What is a grandfathered plan?

 A grandfathered plan is health coverage that was in existence before The Affordable Care Act passed on March 23, 2010. These plans are excluded from ACA regulations.  

What is a grandmothered plan?

 A grandmothered plan is health coverage that was established between March 23, 2010 and the end of 2013. Grandmothered plans were originally intended to follow ACA requirements, but the majority of the act’s regulations weren’t active until January 1, 2014.  Since there was a delay between the act’s passing and establishment of the regulations, plans created during this time were exempt from some but not all ACA requirements.

What is the non-enforcement policy?

 Originally, grandmothered plans were granted to renew on October 1, 2014 through September 30, 2015. This was the first transitional relief for grandmothered plans that later became known as the non-enforcement policy. Since the inception of the ACA, grandmothered plan coverage has been extended to following year via the non-enforcement policy.