42 USC 18011 – Preservation of right to maintain existing coverage
(a) No changes to existing coverage
(1) In general
Nothing in this Act (or an amendment made by this Act) shall be construed to require that an individual terminate coverage under a group health plan or health insurance coverage in which such individual was enrolled on March 23, 2010.
(2) Continuation of coverage
Except as provided in paragraph (3), with respect to a group health plan or health insurance coverage in which an individual was enrolled on March 23, 2010, this subtitle and subtitle A (and the amendments made by such subtitles) shall not apply to such plan or coverage, regardless of whether the individual renews such coverage after March 23, 2010.
(3) Application of certain provisions
The provisions of sections 2715 [42 U.S.C. 300gg-15] and 2718 [42 U.S.C. 300gg-18] of the Public Health Service Act (as added by subtitle A) shall apply to grandfathered health plans for plan years beginning on or after March 23, 2010.
(4) Application of certain provisions
(A) In general
The following provisions of the Public Health Service Act [42 U.S.C. 201 et seq.] (as added by this title) 1 shall apply to grandfathered health plans for plan years beginning with the first plan year to which such provisions would otherwise apply:
(i) Section 2708 [42 U.S.C. 300gg-7] (relating to excessive waiting periods).
(ii) Those provisions of section 2711 [42 U.S.C. 300gg-11] relating to lifetime limits.
(iii) Section 2712 [42 U.S.C. 300gg-12] (relating to rescissions).
(iv) Section 2714 [42 U.S.C. 300gg-14] (relating to extension of dependent coverage).
(B) Provisions applicable only to group health plans
(i) Provisions described
Those provisions of section 2711 [42 U.S.C. 300gg-11] relating to annual limits and the provisions of section 2704 [42 U.S.C. 300gg-3] (relating to pre-existing condition exclusions) of the Public Health Service Act (as added by this subtitle) shall apply to grandfathered health plans that are group health plans for plan years beginning with the first plan year to which such provisions otherwise apply.
(ii) Adult child coverage
For plan years beginning before January 1, 2014, the provisions of section 2714 of the Public Health Service Act [42 U.S.C. 300gg-14] (as added by this subtitle) shall apply in the case of an adult child with respect to a grandfathered health plan that is a group health plan only if such adult child is not eligible to enroll in an eligible employer-sponsored health plan (as defined in section 5000A(f)(2) of title 26) other than such grandfathered health plan.
(5) Application of additional provisions
Sections 300gg-111, 300gg-112, and 300gg-117 of this title shall apply to grandfathered health plans for plan years beginning on or after January 1, 2022.
(b) Allowance for family members to join current coverage
With respect to a group health plan or health insurance coverage in which an individual was enrolled on March 23, 2010, and which is renewed after such date, family members of such individual shall be permitted to enroll in such plan or coverage if such enrollment is permitted under the terms of the plan in effect as of March 23, 2010.
(c) Allowance for new employees to join current plan
Terms Used In 42 USC 18011
- Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
- Dependent: A person dependent for support upon another.
- individual: shall include every infant member of the species homo sapiens who is born alive at any stage of development. See 1 USC 8
A group health plan that provides coverage on March 23, 2010, may provide for the enrolling of new employees (and their families) in such plan, and this subtitle and subtitle A (and the amendments made by such subtitles) shall not apply with respect to such plan and such new employees (and their families).
(d) Effect on collective bargaining agreements
In the case of health insurance coverage maintained pursuant to one or more collective bargaining agreements between employee representatives and one or more employers that was ratified before March 23, 2010, the provisions of this subtitle and subtitle A (and the amendments made by such subtitles) shall not apply until the date on which the last of the collective bargaining agreements relating to the coverage terminates. Any coverage amendment made pursuant to a collective bargaining agreement relating to the coverage which amends the coverage solely to conform to any requirement added by this subtitle or subtitle A (or amendments) shall not be treated as a termination of such collective bargaining agreement.
(e) Definition
In this title,1 the term “grandfathered health plan” means any group health plan or health insurance coverage to which this section applies.