Ohio Insurance Laws and Regulations Practice Exam

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How would a grandfathered health plan under the Affordable Care Act lose its grandfathered status?

  1. By changing the policyholder's address

  2. The insurer significantly raises co-insurance charges, deductibles, or co-payment charges

  3. Offering new benefits

  4. Expanding the coverage area

The correct answer is: The insurer significantly raises co-insurance charges, deductibles, or co-payment charges

When a grandfathered health plan significantly raises co-insurance charges, deductibles, or co-payment charges, it would lose its grandfathered status. This is because one of the requirements for a grandfathered health plan is that it must maintain its original benefits and cost-sharing arrangements without significant changes. Changing the policyholder's address (A), offering new benefits (C), or expanding the coverage area (D) do not necessarily affect the benefits and cost-sharing arrangements of the original plan, therefore would not cause it to lose its grandfathered status.

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