Preventive Services for Grandfathered Health Plans

JOSH GREEN, M.D. GOVERNOR | KE KIAʻĀINA SYLVIA LUKE LIEUTENANT GOVERNOR | KA HOPE KIAʻĀINA STATE OF HAWAII | KA MOKUʻĀINA ʻO HAWAIʻI DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS KA ʻOIHANA PILI KĀLEPA INSURANCE DIVISION 335 MERCHANT STREET, ROOM 213, HONOLULU, HAWAII 96813 P.O. BOX 3614, HONOLULU, HAWAII 96811 Phone Number: (808) 586-2790 Fax Number: (808) 587-6714 cca.hawaii.gov/ins/ NADINE Y. ANDO DIRECTOR | KA LUNA HOʻOKELE JERRY L. BUMP ACTING INSURANCE COMMISSIONER July 11, 2025 MEMORANDUM 2025-5H To: All Health Insurance Companies, Mutual Benefit Societies, and Health Maintenance Organizations Authorized to Write Health Insurance in Hawaii From: Jerry L. Bump, Acting Insurance Commissioner Subject: Preventive Services for Grandfathered Health Plans This Memorandum is directed to all insurance companies, mutual benefit societies, and health maintenance organizations authorized to write health insurance in the State. The Affordable Care Act (ACA) established coverage for certain preventive care benefits without cost-sharing by non-grandfathered health plans. Grandfathered health plans are exempt from some ACA requirements, including offering certain preventive services. The Insurance Division encourages all insurance companies, mutual benefit societies, and health maintenance organizations authorized to write health insurance in the State to consider voluntarily providing grandfathered health plan coverage of preventive services as established by the ACA and in effect on July 1, 2025. The Insurance Division believes that providing these benefits will improve the overall health and well-being of plan members and reduce long-term costs by promoting the early detection of serious health conditions. Thank you for your commitment to providing quality health care coverage to the people of Hawaii. Please contact the Insurance Division at ihealth@dcca.hawaii.gov or (808) 586-2790 if you have any questions regarding this matter. JB