Due to the large volume of members with grandfathered and interim coverage, we have created a rate book for those products. Interim products are non-grandfathered, but use the grandfathered rates. These rates are for existing grandfathered and interim products only.
As a reminder, grandfathered policies are ones purchased prior to March 23, 2010. Interim policies are ones purchased between March 23, 2010 and Sept. 23, 2010 that also have effective dates between April 1, 2010 and Sept. 15, 2010.
Grandfathered members can change benefits and retain grandfathered status. They can only “downgrade” benefits and stay within the same plan, however. For example, a member with a Personal Blue® Plan I with a $250 deductible, 80 percent in-network benefit, and $1,500 out-of-pocket maximum can change his or her out-of-pocket maximum to $2,500 and retain grandfathered status. We will make these changes without requiring underwriting until Nov. 30, 2012. Beginning Dec. 1, 2012, members will have to apply for a non-grandfathered policy and will be required to go through underwriting. If a member would like to “upgrade” benefits, he or she must reapply for coverage, go through underwriting and will lose grandfathered status.
Interim members cannot make changes without losing interim status. Interim members can make benefit changes over the phone through Nov. 30, 2012 without going through underwriting, but we will move them to an SE product. If an interim member would like to make changes on or after Dec. 1. 2012, he or she will be required to submit an application and go through underwriting.
You can download a copy of the grandfathered rates from Storefront.
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