Grandfathered Plan Status Notification
This Plan believes that all health plan options offered are each a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that this Plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits.

Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to Benny’s Cafe at 1-888 873-8326. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform/ This website has a table summarizing which protections do and do not apply to grandfathered health plans.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums.

The following list of States is current as of January 22, 2010. You should contact your State for further information on eligibility – CALIFORNIA – Medicaid
Website: http://www.dhcs.ca.gov/ Pages/default.aspx
Phone: 1-800-635-2570

To see if any more States have added a premium assistance program since January 22, 2010, or for more information on special enrollment rights, you can contact either:

U.S. Department of Labor U.S. Department of Health and Human Services
www.dol.gov/ebsa www.cms.hhs.gov

Employee Benefits Security Administration Centers for Medicare & Medicaid Services
1-866-444-EBSA (3272) 1-877-267-2323, Ext. 61565