Grandfathered Health Plan

The Welfare Fund of the International Union of Operating Engineers, Local 15, 15A, 15C and 15D located at 44-40 11th Street, Long Island City, New York 11101, is a “grandfathered health plan” under § 1251 of the Patient Protection and Affordable Care Act (the “Affordable Care Act”). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your Plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on essential benefits.

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 can be directed to the plan administrator at the above address or telephone number.  You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at (866) 444-3272 or at ‘www.dol.gov/ebsa/healthreform’. This website has a table summarizing which protections that do and do not apply to the grandfathered health plans.