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As of: August 05, 2010 0
eceived: August 04, 201
PUBLIC Soe
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-2010-0010-0025
Comment on FR Doc # 2010-14488

Submitter Information

Name: Barbara Walker
Address:
1580 Logan Street
Ste. 510
Denver, CO, 80203
Email: bwalker@ibcbanks.org
Phone: 303-832-2000
Fax: 303-832-2040
Submitter's Representative: Barbara Walker Executive Director
Organization: Independent Bankers of Colorado and IBC Education Foundation
Government Agency Type: Federal
Government Agency: HHS

General Comment

The Independent Bankers of Colorado is a smali 501(c)(6) trade association comprised of focal
community bank members in Colorado (IBC). The Independent Bankers of Colorado Education
Foundation is a small 501(c)(3) education foundation (IBCEF). Together, the IBC and IBCEF have
three (3) employees. Especially in light of the devastating impact the Interim Final Rules
regarding grandfathered health plans under the Patient Protection and Affordable Care Act (Act)
would have on our non-profit entities, we appreciate this opportunity to comment.

For several years, we have struggled with our ability to obtain good, affordable health insurance
coverage. We lack the economic clout of larger enterprises and find ourselves captive to a small
number of private health insurance providers. We are repeatedly forced, year after year, into
plans offering less and less coverage for our employees. We do not have the resources or ability
to self-insure as a means to control our health insurance costs and benefits.

We believe we will benefit from the expanded options for health insurance under the Act that will

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be available beginning in 2014 through the “exchange” that will allow “pooling”, which is not
currently available. However, because the benefits of the exchange will not be realized until
2014, we will continue to experience annual cost increases and lack of control over actual
coverage until 2014. As such, the grandfathering of their existing coverage is extremely
important, especially prior to the establishment of a working exchange system.

We are greatly concerned that the grandfather provisions outlined in the Interim Final Rules are
too restrictive and will cause us to lose the grandfathering we need. If forced to consider options
of a non-grandfathered pian before we have the benefit of an exchange, we are concerned we will
be priced out of the market and may even have to drop coverage—something we do not want to
do. This would be an enormously bizarre result given the intent of health care reform.

Although there are subsidies available for small employers to help offset the costs of providing
insurance, these credits are very limited. The credits are also phased out for employers with even
modest-sized compensation packages. Because we are at the mercy of health insurance plans
sold by private carriers and have little control over copays and cost sharing, even simple changes
to plans beyond our control can cause our plan to lose grandfather status. Since the exchange is
not currently in place, we anticipate that the prospect of finding new affordable insurance that
meets the new requirements of the Act is problematic at best. We are concerned that Interim
Final Rules as currently drafted may force us to make the difficult and undesirable choice of
canceling health care coverage if grandfather status is revoked, especially before the exchange is
in place.

We suggest for the transition period before the exchange is established, that small and medium
sized employers be allowed to make cost saving changes to copayments and cost sharing
provided they do not materially reduce the per-employee amount they pay for insurance. This
could help organizations like ours adjust and preserve coverage in anticipation of greater reform
and options that will occur beginning in 2014. We also suggest that small and medium sized
employers be allowed to change insurance carriers prior to 2014 and have their plans treatec as
grandfathers plans provided that they do not materially reduce the per-employee amount they
pay for insurance. This would allow us to maintain an adequate level of coverage for our
employees, while being able to reap the benefit of a less expensive plan prior to the
implementation of the exchange.

Thank you for this opportunity to express our views on this important issue.

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