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LEGAL PROCESSING DIVISION 


PUBLICATION & REGULATIONS 


BRANCH 


As of: August 26, 2010 

Received: August 10, 2010 

Status: Posted 

Posted: August 26, 2010 

Tracking No. 80b2d34f 

PUBLIC 

SUBMISSION Comments Due: August 16, :2010 

Submission Type: Web 

Docket: IRS-2010-0010 

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

Health Plan Under the Patient Protection and Afforable Care Act 

Comment On: IRS-2010-0010-0001 

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

a Grandfathered Health Plan under the Patient Protection and Affordable Care Act 

Document: IRS-2010-0010-0464 

Comment on FR Doc # 2010-14488 

Submitter Information 

Name: David Nelson Price 

Address: 

9508 Fairview Ave 

Boiseq, ID, 83704 


Email: pricechiro@cableone.net 


Phone: 208-323-1313 


Fax: 2083231386 


General Comment 

Office of Consumer Information and Insurance Oversight 


Department of Health and Human Services 


Attention: OCIIO-9991-IFC 


P.O. Box 8016 


Baltimore, MD 21244-1850 


Re: Interim Final Rule for Group Health Plans and Health Insurance Coverage Relating to Status 

as a Grandfathered Health Plan Under the Patient Protection and Affordable Care Act 

Below are my comments regarding the Interim Final Rule for Group Health Plans and Health 

Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient 

Protection and Affordable Care Act (PPACA). 

I believe that every effort should be made to increase the number of individuals covered by 

PPACA, especially as of January 1, 2014 when most of the reform components (Insurance 

Exchanges, Subsidies, Tax Credits, etc.) come into play. 

The average consumer has a broad definition of "benefits." Consumers view their health plan 

beyond the covered benefits, cost sharing, and the contribution levels associated with the plein. 

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It is my opinion that the Rule may still result in some confusion to the marketplace in its 

application. For example, if an employer raised the copayment level beyond the maximum in one 

area (i.e. outpatient services) but retained the copayment level for primary care doctor visit5;, 

does that mean a loss of grandfather status? Clarity will be critical both for the employer anci the 

employee. 

Even by the most optimistic estimates, a substantial portion of the employee population will 

remain outside the PPACA as of January 2014 based on the current rules. While I understand the 

difficulty involved in making change, creating another large sub-population of excluded 

individuals will only add to costs, increase confusion, and mitigate the potential impact of the 

legislation. 

The Rule needs to be clear, reasonable, and with no ambiguities involved in determining WhE!ther 

a group health plan is "in or out." The decisions the federal government makes today will 

determine the outcomes for tomorrow 

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