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Grandfathered Plan Notice

Discloses the plan's grandfathered status under the ACA. Use only for clients maintaining a grandfathered plan.

Companies Eligible

Employers with 15+ employees that request medical information, and any client with a wellness program that collects health information.

GINA Title II (employment) applies to employers with 15 or more employees. Title I applies to every group health plan regardless of size: no underwriting on genetic information and no requiring genetic tests. In practice the notice matters when the client asks employees for medical information (FMLA certification, ADA accommodation, fitness for duty) or runs a wellness program with a health risk assessment or biometric screening.

What it is

The notice explains GINA protections. The operational piece is the EEOC safe-harbor statement: when the employer requests medical information, it tells the health care provider not to supply genetic information, including family medical history. Including it means any genetic information the employer receives anyway is treated as inadvertent rather than a violation.

What needs to be done

  • When: Attach the safe-harbor statement to every request for medical information. For wellness programs, include it with the HRA or screening materials.
  • To whom: The employee (and through them, the provider) on each request; wellness participants.
  • Who performs: HR; the wellness vendor for program materials.
  • Customize: None. If the wellness program collects family medical history, add a written, voluntary authorization — and the reward cannot depend on answering those questions.
  • Deliver: With the request or the program materials.
  • Keep: The forms and program materials in use, by year.

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