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Kaiser Permanente Statement on the Continuation of Coverage for Individual Plan Members Under the Affordable Care Act

October 25, 2013

TOPICS: Operational Excellence | REGIONS: National 



Recent news stories have created confusion over the issue of whether consumers in individual health plan products — that are not compliant with the Affordable Care Act — are having their health coverage cancelled or terminated. What is important to understand is that individuals, including Kaiser Permanente members, with discontinued, non-compliant products, are being provided modified plans that are ACA-compliant and include comparable health care services. This allows them to continue their coverage without interruption, even though their old non-compliant plan can no longer be offered.

Kaiser Permanente members who purchased their individual health coverage before March 23, 2010, are considered “grandfathered” under the law and in most cases can keep their existing coverage to comply with the ACA, so long as they don’t make substantive changes. However, members who first purchased individual health coverage after March 23, 2010, are not grandfathered. These members are being provided new, ACA-compliant plans that will enable them to continue their coverage without cancellation or termination.

Approximately 2.5 percent of Kaiser Permanente members are in non-grandfathered individual plans. As required by law, we informed these members that their non-compliant plans will be withdrawn, but that we are ready to continue their coverage in new, ACA-compliant products in 2014. We provided our members with information about the continuation of their coverage, along with information about their choices on how to obtain federal financial assistance, if they are eligible, through their state health care exchange.