Which of the following actions would result in losing grandfathered status under the ACA?

Losing grandfathered status under the Affordable Care Act (ACA) occurs when a health plan undergoes significant changes that do not comply with the requirements to retain that status. Grandfathered plans are those that were in existence on March 23, 2010, and have not made major modifications to their benefits or cost-sharing structures.

Increasing an employee's premium contribution by more than 5% is a key trigger for losing grandfathered status. Specifically, a plan will lose its grandfathered status if the increase in premium contributions exceeds this threshold, as it constitutes a significant change in the plan's cost-sharing arrangements. This is particularly important because grandfathered plans are exempt from certain ACA requirements, which means that maintaining the original cost structure is crucial for retaining that status.

The other actions mentioned, such as maintaining the same deductible since 2010 or keeping the contribution rate steady, do not result in losing grandfathered status. Retaining benefits for preventative care is also essential to keep the plan's grandfathered status. Plans must be cautious about making changes that can affect their compliance with the ACA's grandfathering rules, especially related to costs borne by employees.