New ACA Rules for Allowing Individuals to Keep Plans, Limits on Out-of-Pocket Costs, and Next Exchange Open Enrollment

March 6, 2014

On Wednesday, the Obama Administration announced several new key rules and dates for ACA implementation. The rule that received the most attention was about allowing individuals to keep their existing plans in the private individual insurance market, known as “grandfathered plans,” even if they do not comply with the new ACA rules. People who would like to stay enrolled in their health plan can now continue to do so until 2015, should their insurance company continue to offer the plan. In California, the impact of this rule change will be relatively limited because Covered California requires its participating insurance companies to cancel their existing non-ACA-compliant plans. So, only plans offered by carriers outside of the Exchange will be able to continue offering  non-compliant plans here in California.

In addition, the new rules updated the limits on consumer out-of-pocket costs for health insurance plans 2015. The maximum amounts will be $6,600 for an individual and $13,200 for a family.

The announcement also set the dates for the next open enrollment period for health insurance exchanges. Individuals will be able to change or newly enroll in Exchange plans from November 15, 2014 to February 15, 2015. This period will be one month longer than previously planned, but shorter than the longer open enrollment period (October 1, 2013 through March 31, 2014) for the current plan year.

For the Kaiser Health news article describing the new rules, click here.