If a product is “grandfathered” for a member, it means that the member and their covered dependents are eligible for the benefit amount or rate of this product although that amount or rate is no longer available to other members. In order for a product to be grandfathered, a member and their covered dependents must have been previously enrolled in the product.
Only life and worksite products can be grandfathered in Maxwell Health. If a group's benefits strategy includes grandfathered products, you’ll indicate that on the Pre-Build Form.
In this article, you’ll learn what a member will see in Maxwell Health when they are currently enrolled in a grandfathered product and are shopping for benefits, how a member can change the details or waive their grandfathered product when shopping for benefits, and how the grandfathered product will appear when viewing the benefits in which they are currently enrolled.
How a grandfathered product will appear when shopping for benefits
When a member is enrolled in a grandfathered product and is shopping for benefits, they will see information about the grandfathered status of the product, with the corresponding product tile below the information.
Members are instructed not to take any action if they would like to continue receiving their grandfathered product with the existing plan details, as they will be automatically re-enrolled in this product. If they click See detailed rates and coverage, they are taken to a page with more information about the grandfathered product. This is the same view members will see year-round, even when they’re not shopping for benefits.
How a member continues their enrollment in a grandfathered product
Members should not take action on the grandfathered product when they are shopping for benefits, if they would like to continue their enrollment in that product. They will shop for all of their other available benefits, and by clicking Submit Enrollment at the end of the shopping experience, they are confirming they want to continue to be enrolled in the grandfathered product.
How a member waives or changes the details of their grandfathered product when shopping for benefits
If a member is in an open enrollment and waives or changes the details (e.g. coverage level) of the grandfathered product, they will lose their grandfathered status, and won’t be able to enroll in this plan at any point in the future. However, if a member decides they would like to waive the grandfathered product, or change the details of that product, they can do so by clicking the corresponding product tile below the grandfathered plan information, and make the changes there. Once the member clicks Submit Enrollment at the end of the shopping experience, they will no longer be able to go back and decide they would like to continue their enrollment in the grandfathered product.
How a grandfathered product will appear when viewing currently enrolled products
When a member views their currently enrolled products, their grandfathered product will appear just like any other product, except the effective end date of the product will state “ONGOING.”