In Florida health insurance terminology, what is a 'grandfathered' group health plan?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A grandfathered group health plan is one that was in force when the federal health care reform law was enacted and has been maintained continuously since then, so it is not required to adopt every later minimum benefit standard. Under Chapter 627, Florida Statutes, group health policies remain subject to Florida regulation by the Office of Insurance Regulation, but grandfathered plans may retain certain pre-reform provisions that non-grandfathered plans cannot use. This preserves the employer's existing bargain so long as the plan is not later changed in ways that forfeit grandfathered status.
Why the other options are wrong
- B) Grandfathered status does not exempt a plan from Florida insurance regulation; the plan remains subject to Chapter 627, Florida Statutes, and to oversight by the Office of Insurance Regulation.
- C) Merely renewing a plan with the same insurer does not make it grandfathered; the plan must have been in force continuously since before the health care reform law took effect.
- D) Grandfathered status relates to when the plan itself became effective, not to the hiring dates of the employees it covers.
Memory hook
Grandfathered = the 'grand OLD plan' — old enough to keep its old rules.