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Washington State Office of the Insurance Commissioner

Health care reform FAQs from rates and forms filers

This page has been updated to reflect new information we've received. We'll continue to update this page, so please check back often.

General Questions and answers

Q: What does “health plan” mean for the purpose of The Patient Protection and Affordable Care Act (PPACA)?

A: “Health plan” means health insurance coverage and a group health plan as defined by Sections 2791(a) & (b) of the Public Health Service Act (see link above, in Related Resources).

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Q: What is a “grandfathered” plan?

A: A “grandfathered” plan is any group or individual health plan that was in force on or before March 23, 2010.  A plan remains “grandfathered” even if it can be renewed or new employees and dependents may be added to the plan after March 23, 2010.

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Q: What is a “non-grandfathered” plan?

A: A “non-grandfathered” plan is any group or individual health plan that was issued or became effective on or after March 24, 2010.

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Q: Does the PPACA apply to “grandfathered” plans?

A: Yes, but the requirements that must be implemented within a short time differ slightly for these plans and those that are “non-grandfathered.” 

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Q: Do “grandfathered” plans include those plans that are currently being administered but are no longer being marketed?

A: Yes, as long as the plan meets the “health plan” definition noted above.   Note that this will impact plans that have not been marketed for several years.

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Q: Is a group still considered “grandfathered” if the group sponsor wants to change or add a benefit?

A: This is not specifically addressed in the PPACA. Certain benefit changes may or may not constitute discontinuation, placing the plan outside of the scope of being “grandfathered.”  We are doing further analysis of this issue.  Refer back to this FAQ for updates. 

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