Disclosure and Recordkeeping
Requirements for Grandfathered Health Plans under the Affordable
Care Act (CMS-10325)
Extension without change of a currently approved collection
No
Regular
04/15/2022
Requested
Previously Approved
36 Months From Approved
06/30/2022
1,190
3,424
40
114
1,541
3,424
Section 1251 of the ACA provides that
certain plans and health insurance coverage in existence as of
March 23, 2010, known as grandfathered health plans, are not
required to comply with certain statutory provisions in the Act.To
maintain its status as a grandfathered health plan, the interim
final rule (75 FR 34538, June 17, 2010) require the plan to
maintain records documenting the terms of the plan in effect on
March 23, 2010, and any other documents that are necessary to
verify, explain or clarify status as a grandfathered health
plan.The plan must make such records available for examination upon
request by participants,beneficiaries, individual policy
subscribers, or a State or Federal agency official. A grandfathered
health plan is also required to include a statement in any plan
material provided to participants or beneficiaries describing the
benefits provided under the plan or health insurance coverage, the
plan or coverage believes it is a grandfathered health plan within
the meaning of section 1251 of the ACA, that being a grandfathered
health plan means that the plan does not include certain consumer
protections of the ACA, and providing contact information for
participants to direct 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 grandfathered health
plan status and to file complaints. The amendment to the interim
final rule (75 FR 70114, November 17, 2010) requires a
grandfathered group health plan that is changing health insurance
issuers to provide the succeeding health insurance issuer (and the
succeeding health insurance issuer must require) documentation of
plan terms (including benefits, cost sharing, employer
contributions, and annual limits) under the prior health insurance
coverage sufficient to make a determination whether the standards
of paragraph (g)(1) of the interim final regulations are
exceeded.
PL:
Pub.L. 111 - 148 1251 Name of Law: Preservation of right to
maintain existing coverage.
The burden has been updated to
take into account recent data and that the number of grandfathered
plans has decreased every year since 2011 and that the one-time
costs have already been incurred by grandfathered plans. The burden
hours have decreased by approximately 74 hours (from 114 hours to
40 hours) for grandfathered plan change in carrier disclosures,
since there is a decrease in the estimated number of grandfathered
state and local government plans that are expected to change
carriers.
$0
No
No
No
Yes
No
No
No
Jamaa Hill 301 492-4190
No
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
CMS-10325 Supporting Statement - 30d.docx
Grandfathered Plan Change in Carrier Disclosure