The Trustees of the Electrical Welfare Trust Fund believe that the Plan is a “grandfathered health plan” under the PPACA.
The Electrical Welfare Trust Fund uses collectively bargained employer contributions to the Plan, and income from the investment of Plan assets, to provide the most generous health benefits that are prudently possible, and as supported by the assets of the Plan. To avoid the financial and administrative burdens on the Plan that would be associated with full implementation of the PPACA, the Trustees have decided to operate the Plan as a “grandfathered health plan” as permitted under the PPACA. A “grandfathered plan” is a health plan that was in existence on March 23, 2010, the enactment date of the PPACA. As permitted by the PPACA, a grandfathered health plan can preserve certain basic health benefits that were already in effect when that law was enacted. Being a grandfathered health plan means that the Plan may not include certain consumer protections of the PPACA that apply to non-grandfathered health plans. For example, the requirement that the health plan offer coverage for “preventive” health services without any cost sharing would apply to a non-grandfathered plan, but under a “grandfathered” plan any such services would be covered pursuant to the terms of the Plan in effect on March 23, 2010. However, grandfathered plans must comply with certain other consumer protections in the PPACA such as coverage of health benefits for dependent children (biological and adopted or placed for adoption) up to age 26 (the end of the month in which the child reaches age 26).
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 a grandfathered health plan status to non-grandfathered status can be directed to:
Electrical Welfare Trust Fund
10003 Derekwood Lane, Suite 130
Lanham, MD 20706-4811
You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans.