Previously, HHS issued guidance on the process a group health plan or health insurance issuer must follow to apply for a waiver for a limited benefit plan or "mini-med" plan of the restrictions on the imposition of annual limits on the dollar value of essential health benefits. The waiver does not extend beyond plan or policy years beginning on or after January 1, 2014, except for grandfathered individual market policies.
The new guidance issued on December 9, 2010 clarifies that waivers of annual limit restrictions pursuant to the waiver authority generally applies only to insured policies in place before September 23, 2010. Except for the limited exceptions discussed below, health insurance issuers cannot provide new policies to group health plans or sell new policies in the individual market after September 23, 2010 that do not meet the requirements of the Public Health Service Act (PHS).
The two exceptions to the restriction are state mandated policies and group policies that have policies with waivers and purchase new policies from different issuers that also have waivers. However, if a new policy includes certain changes provided in the grandfather interim final regulations, the plan will continue to cease to be a grandfathered health plan.