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Grandfathered Plan Verification and Registration

Under the new health care reform law called the Patient Protection and Affordable Care Act health plans in existence on March 23, 2010 may be eligible for “grandfathered” status.

If you had an Aetna group health plan on March 23, 2010, this site will:

  • Help you verify if your renewal plan may retain grandfathered status, and if so
  • Allow you to register your plan with Aetna as a grandfathered plan.

To use this site you will need to reference your renewal package to:

  • Assess any proposed or required plan changes compared to the benefits you had in place as of March 23, 2010.
  • Utilize plan identification information to register plan grandfathering status for your renewed plan.

Additional information on grandfathering

NOTE:  Grandfathered status must be reflected in your plan documents. When you complete this registration Aetna will review your information and send you an insert page for your policy and your members’ coverage certificates for qualifying renewed plans. Please distribute this insert page to your participating employees for insertion in their plan documents.

You should retain a copy of your benefit designs and documentation of your contribution levels for any grandfathered plan for future testing purposes and advise Aetna if this information changes throughout the year.

Proceed

This refers to the name of the policy or contract holder.

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Individual completing this certification

Aetna Plan Identification Number

Please provide the information to the right for plans you intend to grandfather. The requested information can be found within your renewal package. For additional instruction on completing the request please utilize the information icon for each field.

For all fields please provide the information applicable to the renewal plan. Dental, Life, and Disability plans are not subject to PPACA legislation.

You may submit up to five plans on each submission and will be given the option to certify additional plans if needed.

Plan 1

This field refers to the identification number assigned to your policy and consists of a series of six numbers.
It may be listed as: Group#, Control#, Policyholder#, Contractholder#

This field is utilized by Small Group Plans. Your Plan ID will be found on the Medical Plan information grid in your renewal package.

The Plan name refers to the name of your Medical Plan.

For HMO Plan types if all locations qualify for Grandfathered status you may select ALL. If not, please list each state you intend to certify.

In this field please provide the date of renewal of your plan.
Please note: Grandfather certification submissions will be accepted no more than 60 days prior to the renewal effective date.

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Plan 2

This field refers to the identification number assigned to your policy and consists of a series of six numbers.
It may be listed as: Group#, Control#, Policyholder#, Contractholder#

This field is utilized by Small Group Plans. Your Plan ID will be found on the Medical Plan information grid in your renewal package.

The Plan Name refers to the name of your Medical Plan.

For HMO Plan types if all locations qualify for Grandfathered status you may select ALL. If not, please list each state you intend to certify.

In this field please provide the date of renewal of your plan.
Please note: Grandfather certification submissions will be accepted no more than 60 days prior to the renewal effective date.

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Plan 3

This field refers to the identification number assigned to your policy and consists of a series of six numbers.
It may be listed as: Group#, Control#, Policyholder#, Contractholder#

This field is utilized by Small Group Plans. Your Plan ID will be found on the Medical Plan information grid in your renewal package.

The Plan Name refers to the name of your Medical Plan.

For HMO Plan types if all locations qualify for Grandfathered status you may select ALL. If not, please list each state you intend to certify.

In this field please provide the date of renewal of your plan.
Please note: Grandfather certification submissions will be accepted no more than 60 days prior to the renewal effective date.

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Plan 4

This field refers to the identification number assigned to your policy and consists of a series of six numbers.
It may be listed as: Group#, Control#, Policyholder#, Contractholder#

This field is utilized by Small Group Plans. Your Plan ID will be found on the Medical Plan information grid in your renewal package.

The Plan Name refers to the name of your Medical Plan.

For HMO Plan types if all locations qualify for Grandfathered status you may select ALL. If not, please list each state you intend to certify.

In this field please provide the date of renewal of your plan.
Please note: Grandfather certification submissions will be accepted no more than 60 days prior to the renewal effective date.

/
/

Plan 5

This field refers to the identification number assigned to your policy and consists of a series of six numbers.
It may be listed as: Group#, Control#, Policyholder#, Contractholder#

This field is utilized by Small Group Plans. Your Plan ID will be found on the Medical Plan information grid in your renewal package.

The Plan Name refers to the name of your Medical Plan.

For HMO Plan types if all locations qualify for Grandfathered status you may select ALL. If not, please list each state you intend to certify.

In this field please provide the date of renewal of your plan.
Please note: Grandfather certification submissions will be accepted no more than 60 days prior to the renewal effective date.

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* Aetna cannot guarantee that grandfathering will be available for all plans. Grandfather status will only be reviewed for plan information provided on this form.

Go Back      Proceed

  Group #/
Control #		 Plan ID Plan Name State Renewal Date

Please respond to the following questions which are applicable to all the plans noted above:

Since March 2010 has the plan had zero enrollees during any month?

Have any of the following changes been made to the plan’s benefits since March 23, 2010?

The addition or decrease of an annual dollar limit (except to replace an overall lifetime limit)?
The elimination of a benefit to diagnose or treat a particular condition?
An increase in a percentage member cost-sharing requirement such as coinsurance?
Any increase in a fixed amount member cost-sharing requirement other than a copayment such as a deductible or out-of-pocket limit by more than the Medical CPI plus 15% points?
Any increase in a fixed amount copayment by more than the Medical CPI plus 15% points or $5 adjusted by Medical CPI whichever is greater?
A decrease of more than 5 percentage points in your plan sponsor contribution to the plan premium for coverage or any tier of coverage?
Have you restructured your business to avoid loss of grandfathered status?
Are you aware of any other changes that would cause a loss in grandfathering status?

 

Go Back      Proceed

Note: If you answer "yes" for any of the plans you have identified, the plan will not qualify as grandfathered. You may select "Go Back" and remove that plan from the list on the previous screen.If no plan qualifies as grandfathered you may end your session by closing the browser window.

Based on the information you have provided, your Aetna plan(s) appears to qualify for grandfathered status.

To register the plan(s) as grandfathered you must complete the following:

By checking the box I certify that:

  • I am an authorized representative of the plan(s) for which this registration is being provided.
  • Each plan was in effect on March 23, 2010.
  • All information provided about the proposed renewal benefits for each plan is correct and the plan will be renewed on those terms.
  • All additional information I have provided on the preceding screen is true and correct.
  • Aetna may rely on the responses I have provided.
*Certified by authorized representative

Note: Aetna reserves the right to audit all information provided and, if a discrepancy is discovered, to revoke certification of grandfathered status.

Aetna will retain a record of your submission as you have recorded it. You will receive an email confirmation shortly.

Grandfathered status must be reflected in your plan documents. When you complete this registration Aetna will review your information and send you an insert page for your policy and your members’ coverage certificates for qualifying renewed plans. Please distribute this insert page to your participating employees for insertion in their plan documents.

You should retain a copy of your benefit designs and documentation of your contribution levels for any grandfathered plan for future testing purposes and advise Aetna if this information changes throughout the year.

 

Go Back      Submit

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