The company I work for is self-insured for health insurance purposes. I was told that under the current plan (2014 and earlier), lactation consultants and breast pumps are not covered because the plan is grandfathered in for ACA purposes. I did a bit of research on what blows the grandfathered plan status and found that raising the premiums or deductibles more than (I think it was) 10% or maybe 15% makes a plan no longer grandfathered. Both our premiums and deductibles increased about 25% so I would think the grandfather status is blown. I also found that the company is required to disclose in the plan description whether or not the plan is grandfathered for ACA and if it is grandfathered why this status is in effect (which I would love to know because according to my research they blew the grandfathered status). I asked HR for a copy of the 2015 plan description and they said it isn't ready yet. I talked to the administrator of our plan and asked when I should expect a copy of the 2015 plan description, and they said "oh some companies don't issue them until July but any changes are retroactive to January". I don't understand how claims that come in in January are paid properly if they don't have the updated plan document.
Anyway, just wondering if anyone has any expertise in this area? Maybe someone is in HR? Does anyone know how long the company has to issue the plan document? It seems like there should be some kind of deadline.