Grandmothered Plans Extended Through 2021

On February 19, 2020, the Department of Insurance issued Bulletin Number 2020-01 to announce a one-year extension of the renewal policy with respect to certain non-grandfathered individual and small group policies known as “grandmothered” policies. The bulletin follows an extension by CMS of the federal non-enforcement policy with respect to specific ACA compliance requirements for these grandmothered plans.

As background, on November 14, 2013, CMS issued a letter outlining a transitional policy with respect to the healthcare reform mandates for coverage in the individual and small group markets. This non-enforcement policy provided relief from certain market reforms, such as the prohibition of coverage exclusions based on pre-existing conditions and non-discrimination based on health status. Under the policy, state authorities could allow health insurance issuers to continue eligible coverage that would otherwise have been cancelled for failure to comply with the ACA requirements. The Department originally announced the state’s intent to allow insurers to continue such coverage via Bulletin 2013-12 issued on November 19, 2013. The transitional policy has continually been extended by CMS and the Department since the initial announcement.

Accordingly, small employers who are currently covered by such grandmothered policies issued in South Carolina should be aware of the most recent non-enforcement extension through December 31, 2021. These employers should work with their advisors and insurers regarding possible renewal of the coverage.

SC DOI Bulletin »