The Departments of Labor (DOL) and Health and Human Services (HHS) and the Treasury have finalized a rule for grandfathered group health plans under the Affordable Care Act (ACA) without making any substantive changes from its proposed form.

As we discussed in a prior article reviewing the proposed rule, the final rule provides greater flexibility for plan sponsors to revise cost-sharing amounts for grandfathered plans without causing them to lose their grandfathered status. Specifically, the rule permits a sponsor of a grandfathered group health plan to do the following without jeopardizing the plan’s grandfathered status:

• For a high-deductible health plan (HDHP), to increase fixed-amount cost-sharing requirements, such as deductibles, to the extent necessary to maintain the plan’s status as an HDHP; and
• To use the “premium adjustment percentage” published annually by HHS as an alternative method for measuring permitted increases in fixed-amount cost-sharing.

The final rule applies to grandfathered group health plans and grandfathered group health insurance coverage beginning on June 15, 2021.