ACA Compliance - Understanding Grandfathering and Self Funding

Much has been written and clarified relative to the Affordable Care Act’s (ACA) so called “grandfather” status.  In short, if a group health plan was in effect as of the signing of the law (March 23, 2010), and significant changes have not been made to the design or cost of the plan since that time, the plan is deemed grandfathered by ACA standards.  Several provisions of the law do not apply to plans that have retained such status.  For a complete listing of provisions that are both applicable and non-applicable to grandfathered plans, in addition to the changes that cause a plan to lose such status, click here -  
http://www.familiesusa.org/assets/pdfs/health-reform/Grandfathered-Plans.pdf

This week’s post addresses another type of quasi-ACA compliance exemption, which has to do with how a group health plan is funded (i.e., fully insured or partially self funded).   Historically, employers looked to partially self funding their health plans (and sometimes dental, vision, and short term disability income), in order to benefit from cash flow advantages, better reporting, ERISA preemption, and more plan design flexibility, among other reasons.  Now, employers are starting to consider partial self funding for a whole different reason - ACA compliance strategy!