Section 1251 of the ACA provides that certain plans and health insurance coverage in existence as of March 23, 2010, known as grandfathered health plans, are not required to comply with certain statutory provisions in the Act.To maintain its status as a grandfathered health plan, the interim final rule (75 FR 34538, June 17, 2010) require the plan to maintain records documenting the terms of the plan in effect on March 23, 2010, and any other documents that are necessary to verify, explain or clarify status as a grandfathered health plan.The plan must make such records available for examination upon request by participants,beneficiaries, individual policy subscribers, or a State or Federal agency official. A grandfathered health plan is also required to include a statement in any plan material provided to participants or beneficiaries describing the benefits provided under the plan or health insurance coverage, the plan or coverage believes it is a grandfathered health plan within the meaning of section 1251 of the ACA, that being a grandfathered health plan means that the plan does not include certain consumer protections of the ACA, and providing contact information for participants to direct questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status and to file complaints. The amendment to the interim final rule (75 FR 70114, November 17, 2010) requires a grandfathered group health plan that is changing health insurance issuers to provide the succeeding health insurance issuer (and the succeeding health insurance issuer must require) documentation of plan terms (including benefits, cost sharing, employer contributions, and annual limits) under the prior health insurance coverage sufficient to make a determination whether the standards of paragraph (g)(1) of the interim final regulations are exceeded.
The burden has been updated to take into account that the number of grandfathered plans have been reduced since 2011 and that one-time costs have already been incurred by grandfathered plans. The burden hours have been reduced by 26,000 hours attributed to one-time set up costs for grandfathered health plan disclosures, 26,000 hours related to one-time set up costs for recordkeeping requirements and 115 hours related to grandfathered plan change in carrier disclosures.
$0
No
No
Yes
No
No
Uncollected
William Parham 4107864669
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Grandfathered Plan Change in Carrier Disclosure