1201 Maryland Avenue SW · Suite 900 · Washington, DC 20024 · 202.962.9200 · www.bio.org

August 16, 2010

Mr. Jim Mayhew

Office of Consumer Information and Insurance Oversight

Department of Health and Human Services

P.O. Box 8016

Baltimore, MD 21244-1850

Re: 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

Please Refer to OCIIO-9991-IFC

Dear Mr. Mayhew:

The Biotechnology Industry Organization (BIO) appreciates this opportunity to 

comment on the Department of Health and Human Services’ interim rules related to 

group health plans and grandfathered status under the Patient Protection and 

Affordable Care Act (ACA).

1

 BIO represents more than 1,200 biotechnology companies, 

academic institutions, state biotechnology centers and related organizations across the 

United States and in more than 30 other nations. BIO members are involved in the 

research and development of innovative healthcare, agricultural, industrial and 

environmental biotechnology products. 

BIO represents an industry that is devoted to discovering new preventive tools 

and treatments and ensuring patient access to them. BIO membership includes both 

current and future vaccine developers and manufacturers who have worked closely with 

the public health and advocacy communities to support policies that help ensure access 

to innovative and life-saving vaccines for all individuals. Therefore, we continue to 

monitor those policies and rules that could both positively and negatively impact access 

to vaccinations and subsequently immunization rates.

BIO members understand the need for the architects of ACA to balance the 

objectives of preserving the ability of individuals to maintain their existing coverage, 

giving health plans appropriate time to make the extensive changes 

 

1

75 Fed. Reg. 34538 (June 17, 2010).
Mr. Jim Mayhew

August 16, 2010

Page 2 of 2

and improving the overall quality of healthcare. We note that plans which have 

grandfathered status are not required to disclose which provisions of ACA will and will 

not be covered for each specific plan. Given the overarching objectives of consumer 

awareness and empowered decision-making, we think it is important that health plans 

disclose to plan members which of the plan's insurance products cover preventive 

services, including recommended vaccinations, at first dollar.

The model language included in Section 147.140(a)(2)(ii) of the proposed interim 

rules does include language that helps inform beneficiaries that certain consumer 

benefits may not be included in their plan, but it does not help the consumer easily 

discern the specific provisions. To best understand the extent to which the consumer 

benefits from ACA, such as first dollar coverage for key preventive services, apply to 

their plan, beneficiaries must seek further information from either the health plan or their 

employee benefits department. 

We recommend, as others have suggested, that each grandfathered health plan 

disclose which insurance products it offers cover preventive services and vaccines at 

first dollar. This would enable consumers to easily compare the benefits and also 

realize the important quality improvements afforded by the Act. 

BIO members strongly support provisions that will help ensure access to proven 

preventive services, such as vaccinations. We look forward to future opportunities to 

work with the Department to maximize adoption of the preventive services and quality 

provisions of the Patient Protection and Affordable Care Act.

Conclusion 

BIO appreciates the opportunity to comment on the 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. We look forward to 

continuing to work with HHS to address these critical issues in the future. Please feel 

free to contact me at 202-962-6664 if you have any questions or if we can be of further 

assistance. Thank you for your attention to this very important matter. 

With Sincerest Regards,

Phyllis A. Arthur

Managing Director, 

Immunizations, Immunotherapeutics and Diagnostics
202.962.6664 

parthur@bio.org 

Biotechnology Industry Organization