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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Grandfathered Plan Rate Increase?

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Question: If someone has a grandfathered individual plan, will the rates be locked in till open enrollment next year or can they have increases mid year that may be unfavorable? Which means the client is locked in till open enrollment or does that open a window to make a move to another option?

Answer: Your grandfathered plan rate is only locked in until the policy renewal date, which is the anniversary of the policy”s original effective date of coverage. If that date falls outside off an open-enrollment period, you cannot choose to change plans regardless of the rate increase. That is not a qualifying event. You will not be able to change your plan until the next open enrollment period - Oct 15 to Dec 7 of that year.

1 Comment

I might be mistaken, but I seem to remember getting rate increases from Blue Shield that did not coincide with my personal renewal date. (My renewal was in March, but it seems like the last rate increase was effective in January — I do remember running into problems one year because I was making payments based on an old rate when a new one kicked in.

I know that Blue Shield already announced rate increases for all the grandfathered policies effective January 2014, averaging 9.8% — see https://interactive.web.insurance.ca.gov/apex/f?p=102:2:0::NO for more info.

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