content top new


Notice of Grandfathered Plan

The MILA Trustees believe the Premier Plan, the Basic Plan, and the Core Plan are "grandfathered health plans" 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 your 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 the MILA Executive Director at 212-766-5700. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or access information online at This website has a table summarizing which protections do and do not apply to grandfathered health plans.

The MILA Medicare Wrap-Around Plan is considered a “retiree-only” plan and is not subject to the requirements of the ACA that define grandfathered plans. Rather, it is exempt from the provisions of the Affordable Care Act because it covers only retired persons and their dependents, and its benefits are provided to supplement those available from Medicare Parts A & B. In addition, it provides prescription drug benefits that qualify as “creditable coverage” under the regulations governing the requirement to enroll in Medicare, Part D. This means that MILA coverage is equal to or better than the coverage provided in Medicare, Part D, and persons covered in the MILA Medicare Wrap-Around Plan are not required to enroll in a Part D Plan.