Preventive Services for Grandfathered Health Plans
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A memorandum encouraging insurers authorized in Hawaii to voluntarily provide ACA-established preventive services coverage without cost-sharing to members of grandfathered health plans as of July 1, 2025; affects all health insurance companies, mutual benefit societies, and HMOs authorized in Hawaii.
No material clinical or coverage changes in this revision.
Preventive Services Coverage Recommendation
Preventive services coverage recommendation
Stance and recommendation regarding coverage of preventive services for grandfathered plans:
Recommended Actions for Insurers
Voluntary provision of ACA preventive services for grandfathered plans
The Insurance Division encourages insurers authorized in Hawaii to voluntarily provide coverage under grandfathered health plans for preventive services established by the Affordable Care Act and in effect on July 1, 2025. This is guidance only and does not require insurers to change plan benefits.
- Target audience: all insurance companies, mutual benefit societies, and HMOs authorized to write health insurance in Hawaii.
- Voluntary action: consider providing ACA-established preventive services without cost-sharing for members of grandfathered plans effective as of July 1, 2025.
- Nature of guidance: encouragement only — not a mandate to amend grandfathered plan benefits.
Key Definitions
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