https://fdms.erulemaking.net/.../component/submitterInfoCoverPage?Call=Print&PrintId=0900006480b325d3&Comment=true[8/17/2010 9:53:33 AM]

PUBLIC SUBMISSION

As of: August 17, 2010

Received: August 16, 2010

Status: Pending_Post

Tracking No. 80b325d3

Comments Due: August 16, 2010

Submission Type: Web

Docket: EBSA-2010-0014

Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered

Health Plan Under the Patient Protection and Affordable Care Act

Comment On: EBSA-2010-0014-0001

Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered

Health Plan Under the Patient Protection and Affordable Care Act

Document: EBSA-2010-0014-DRAFT-0018

Comment on FR Doc # N/A

Submitter Information

Address: United States,

Organization: 16 members of the Leadership Conference for Civil and Human Rights' Health Care Task Force

General Comment

Attached please find comments from 16 members of the Leadership Conference for Civil and Human Rights'

Health Care Task Force (listed below) re: File Code OCIIO–9991–IFC/RIN 1210–AB42/REG–118412–10. Interim

Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health

Plan under the Patient Protection and Affordable Care Act. 

// 

AARP;

American Association of People with Disabilities (AAPD);

American Civil Liberties Union;

Asian & Pacific Islander American Health Forum;

Black Women’s Health Imperative;

Families USA;

International Union, United Automobile, Aerospace & Agricultural Implement Workers (UAW);

Japanese American Citizens League;

Legal Momentum;

NAACP;

National Congress of the American Indians;

National Council of Jewish Women;

National Council of La Raza (NCLR);

National Health Law Program;

National Partnership for Women & Families;

National Women’s Law Center.

Attachments

EBSA-2010-0014-DRAFT-0018.1: Comment on FR Doc # N/A
1

August 16, 2010 

Office of Consumer Information and Insurance Oversight 

Department of Health and Human Services 

P.O. Box 8016 

Baltimore, Maryland 21244-1850 

Attention: OCIIO-9991-IFC 

Office of Health Plan Standards and Compliance Assistance 

Employee Benefits Security Administration 

U.S. Department of Labor 

200 Constitution Avenue NW 

Washington, DC 20210 

Attention: RIN1210-AB42 

Internal Revenue Service 

P.O. Box 7604 Ben Franklin Station 

Washington, DC 20044 

Attention: REG-118412-10 

RE: File Code OCIIO–9991–IFC/RIN 1210–AB42/REG–118412–10. Interim Final 

Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a 

Grandfathered Health Plan under the Patient Protection and Affordable Care Act 

Dear Sir or Madam: 

Thank you for the opportunity to comment on the interim final regulations regarding the 

grandfathering provisions of the Patient Protection and Affordable Care Act (ACA). 

Many of the undersigned organizations have submitted comments on several aspects of 

the interim final regulations; however, as members of the Leadership Conference for 

Civil and Human Rights (the Leadership Conference) we collectively are submitting 

these additional separate comments in order to stress the importance of §1557 of the 

ACA. 

Section 1557 of the ACA forbids discrimination on the grounds of sex, race, national 

origin, disability or age in health programs or activities receiving federal financial 

assistance or by programs administered by an Executive Agency or any entity established 

under Title I of the ACA. Because §1557 applies broadly to federally conducted 

programs and to entities that receive federal funding or assistance, it is essential that as 

federal agencies issue regulations for the ACA, they consistently take the mandates of 

§1557 into account and make clear how other ACA regulations interact with §1557. We 

therefore recommend that the Departments clarify in these regulations the application of 

§1557 to grandfathered plans. 

First, we recommend that the Departments make clear that §1557 applies to 

grandfathered plans. As stated in the ACA (§1251) and reiterated by the Departments in 
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the interim final rule regarding grandfathered plans, grandfathered plans are exempt from 

only those provisions contained in subtitles A and C of Title I, with the exceptions noted 

within those subtitles and in the regulations. 75 Fed. Reg. 34559, 34563, 34567. 

Although §1557 does state that it applies “except as otherwise provided for in” Title I, 

nothing in §1251 conflicts with §1557. Thus, because §1557 is in subtitle G and there is 

no conflict with §1251, §1557 applies to grandfathered plans. 

Second, the Departments should clarify that changes made to a health plan in order to 

comply with §1557 will not cause a grandfathered plan to lose its grandfathered status 

unless such changes exceed the limits specified in the interim final rule. 75 Fed. Reg. 

35444. As the explanation of the interim final regulations makes clear, if a health plan 

alters its provisions in order to meet the requirements of federal or state law, including 

the ACA, it will not lose its grandfathered status. However, as would be the case in 

complying with other requirements of the law, if such changes exceed the limits of 

changes set forth in paragraph (g)(1) of the interim regulations, the plan will lose its 

grandfathered status. 75 Fed. Reg. 35444 (“Under these interim final regulations, 

changes other than the changes described in 26 CFR 54.9815– 1251T(g)(1), 29 CFR 

2590.715–1251(g)(1), and 45 CFR 147.140(g)(1) will not cause a plan or coverage to 

cease to be a grandfathered health plan. Examples include changes to premiums, changes 

to comply with Federal or State legal requirements, changes to voluntarily comply with 

provisions of the Affordable Care Act, and changing third party administrators, provided

these changes are made without exceeding the standards established by paragraph (g)(1).” 

(emphasis added)) 

Section 1557 will ensure that as our health care system reaches more Americans and 

makes coverage more affordable, it does so in a manner free from discrimination based 

on the grounds listed in §1557. Therefore, it is important that regulations implementing 

the law, including the final regulations regarding grandfathering status, incorporate 

§1557’s mandate and make covered plans, providers, and other programs aware of their 

obligation to comply with the nondiscrimination protections of the law. 

We look forward to working with you to ensure that the nondiscrimination provisions of 

the ACA are fully integrated into the implementation of health care reform. 

Sincerely, 

AARP 

American Association of People with Disabilities (AAPD) 

American Civil Liberties Union 

Asian & Pacific Islander American Health Forum 

Black Women’s Health Imperative 

Families USA 

International Union, United Automobile, Aerospace & Agricultural Implement Workers 

(UAW) 

Japanese American Citizens League 

Legal Momentum 
3

NAACP 

National Congress of the American Indians 

National Council of Jewish Women 

National Council of La Raza (NCLR) 

National Health Law Program 

National Partnership for Women & Families 

National Women’s Law Center 

cc: Ms. Georgiana Verdugo, Director Office of Civil Rights, HHS 

Dr. Howard Koh, Assistant Secretary for Health, HHS

Dr. Garth Graham, Deputy Assistant Secretary for Minority Health, HHS