Contract Administration To: Executive Board Debomh Stayman, Health Benefits Specialist rato RE: “Granifathered” vs “Non-Grandfathered” Status ‘To honor President Cbama’s pledge that Americans can keep their current plans if they ike them, Congress included a “grandfather” provision applicable to plans in effect before March 23, 2010. ‘To be “grandfathered” a plan must meet several requirements, including: a. Itexised on March 23, 2010. 'b. Itmust not eliminate all or substantially all benefits to diagnose or treat a particular condition, Employers cannot change the percentage of co-premiums it pays by more than 5 Percentage points. 44. Deductibles cannot be increase by more than medical inflation (56% in recent ‘years plus 15%. ce. Co-pays cannot be raised by more than $5 or medical inflation plus 15% (whickever is greater, f. All these increases are CUMULATIVE NOT ANNUAL. Ifa plan increases the ‘co-pay from $5 to $10 one year, it will lose grandfathering if it ever rises the copay again. . Ifaplanis fully-insured and pursuant to a collectively bargained agreement signed prior to March 23, 2010, the plan will remain grandfathered until the agreement expires. ‘The Empire Plan metthese requirements and has been considered a grandfathered plan. Ifthe Executive Board votes to send the tentative agreement tothe general membership for a ‘tification vote, and the members vote to ratify the contract, the changes in the Empire Plan will cause the Plan fo become “Non-Grandfathered” with a proposed effective date of 10/1/11. Asa Non-Grandfathered pan, the Empire Plan must provide preventive services with no copay when received from a Participating Provider as described in the United States Preventive Services,‘Task Force A and B recommendations hup//wworuspreventiveservicestaskforce org/uspstiuspssbrecs.him) the Advisory Committee on immunization Practices (ACIP) under th Centers fr Dense Cont and Prevention (CDC) Schedule ‘OLDAD. The preventive services ae listed in the following able{8300 35g YOUR 20) BuRFaL INU sedoo on ‘Aedo> 1 294ans pasane> | _ 10) uotenjens pue Buyesunos sn2u20- ARIESH SasowoM ‘inssard poorq uy aM Aedo0 on ‘Aedeo o1ratans pararon | sunpe asoun w seiagei 104 BNs22:95. ‘hedo2 On ‘heda> 01 22fgns paranoy | __ainsrerd poor uBio) RuNv99:05- edo ON ‘hedon 1 Delgns parang worssandap 10} BuNNBBI5- ‘WonHanu pue vp Ayseqo “sn ‘cavegon Bum ave Areunid © ut osnge edo> on ‘doo on pafans paranoy | _royoaye 20 Suesunoo pur Buj98I95 "AH Pue saseanp panmusuen edo ON edo on olan parang ‘Ayers wey 04 Bu99.05- ‘spr pe ovasajou> paLenays edo on ‘eden 0 1949ns pa19n09 som one bn 10 sate donde soguu ty PIRTPATE ‘epeayen ‘eoqny sduuny saseoyy YeDDODOUNIUY "ezUENYL ‘edo on s0fgnsparanon(sofuns) 238807 sadson pue syBuquoy feaoanc8nUoHy “tna sein ewontdeg vewnu proxoL snug ‘eyaaven‘eyeqny ‘uni ‘soseayy‘jeoesounoug ‘exvanyu suonerunusi yopy 703 On ‘doo oF BaIq parang {SIA SUDIBOWN antuanag AUS) ZEAE Sooo WOU NON TyeveR wan Es (ated sn uo aprue pares 925) apexes Axpoyied samny 1y6ug Souterpag o Auapeoy uesueWY an Buu SouTIpIND YSHH ata pue (309) UoNUaAaAY PuE tonueg aseasi 2) sete etn Japun (ary) S2anPeLg UoERUMU| Uo BarRUIOD ALORIAPY at SUONEPUOLIWODDH PUR Y 82103 95 antuanand -sateis paqun 2p u paquosep se TIBIRIT MOMERPATEY € WGN] BESET UB hea ou ym pasoncasayaas annuanaid jo ALeUUS € 5) SUMO} UL sera pavee;pues5-von 20) (vada) By 8289 tgepouY pue voRDeLs wane, Ye:9pe4 aya JepUN afEIONCD