42 U.S.C. § 18011 — Preservation of right to maintain existing coverage

(a) No changes to existing coverage

(1) In general

Nothing in this Act or an amendment made by it requires an individual to end coverage under a group health plan^* or health insurance coverage^* in which the individual was enrolled on March 23, 2010.

(2) Continuation of coverage

Except as provided in paragraph (3), this subtitle and subtitle A, and amendments made by those subtitles, do not apply to a group health plan^* or health insurance coverage in which an individual was enrolled on March 23, 2010, even if the individual renews the coverage after that date.

(3) Application of certain provisions

Sections 2715 [42 U.S.C. 300gg–15] and 2718 [42 U.S.C. 300gg–18] of the Public Health Service Act, as added by subtitle A, apply to grandfathered health plans for plan years beginning on or after March 23, 2010.

(4) Application of certain provisions

(A) In general

These provisions of the Public Health Service Act [42 U.S.C. 201 et seq.], as added by this title, apply to grandfathered health plans for plan years beginning with the first plan year to which they would otherwise apply: (i) section 2708 [42 U.S.C. 300gg–7], concerning excessive waiting periods; (ii) the provisions of section 2711 [42 U.S.C. 300gg–11] concerning lifetime limits; (iii) section 2712 [42 U.S.C. 300gg–12], concerning rescissions; and (iv) section 2714 [42 U.S.C. 300gg–14], concerning extension of dependent coverage.

(B) Provisions applicable only to group health plans

(i) Provisions described

The provisions of section 2711 [42 U.S.C. 300gg–11] concerning annual limits and section 2704 [42 U.S.C. 300gg–3], concerning pre-existing-condition exclusions, of the Public Health Service Act, as added by this subtitle, apply to grandfathered health plans that are group health plans for plan years beginning with the first plan year to which those provisions would otherwise apply.

(ii) Adult child coverage

For plan years beginning before January 1, 2014, section 2714 of the Public Health Service Act [42 U.S.C. 300gg–14], as added by this subtitle, applies to an adult child’s coverage under a grandfathered group health plan only if the adult child is not eligible to enroll in an eligible employer-sponsored health plan, as defined in section 5000A(f)(2) of title 26, other than that grandfathered health plan.

(5) Application of additional provisions

Sections 300gg–111, 300gg–112, and 300gg–117 of this title apply to grandfathered health plans for plan years beginning on or after January 1, 2022.

(b) Allowance for family members to join current coverage

For a group health plan or health insurance coverage in which an individual was enrolled on March 23, 2010, and that is renewed after that date, the individual’s family members must be allowed to enroll if the plan’s terms in effect on March 23, 2010, allowed that enrollment.

(c) Allowance for new employees to join current plan

A group health plan that provided coverage on March 23, 2010, may allow new employees and their families to enroll. This subtitle and subtitle A, and amendments made by those subtitles, do not apply to the plan or to those new employees and their families.

(d) Effect on collective bargaining agreements

For health insurance coverage maintained under one or more collective bargaining agreements between employee representatives and one or more employers, when the agreement or agreements were ratified before March 23, 2010, this subtitle and subtitle A, and amendments made by those subtitles, do not apply until the last collective bargaining agreement relating to the coverage ends. A coverage amendment made under such an agreement that changes the coverage only to comply with a requirement added by this subtitle or subtitle A, or their amendments, is not treated as ending the agreement.

(e) Definition

In this title, “grandfathered health plan” means a group health plan or health insurance coverage to which this section applies.