Do you have specific questions about how the new law affects your employees and their families?
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When will this provision take effect? Submitted by Janice, VA
Insurance plans that cover dependents must allow children under the age of 26 to join their parent’s policy for plan years beginning after September 23, 2010. Plans must give young adults who qualify a 30 day “special enrollment period” to enroll for the start of the next plan year. Some insurers moved up the date and are allowing college students currently on their parent's plans to remain on it during the gap. Others companies such as United Technologies decided to implement the full dependent coverage provision immediately.
Does the law require plans to cover young adults who are not financially dependent on their parents? Submitted by Liz, MD
Yes. The new provision does not require a young adult to be a tax dependent in order to enroll for coverage. This is a significant change from a lot of current state dependent coverage laws, which often only require plans to cover young adults who qualify as dependents for purposes of the tax code.
The law in the state where I do business already requires our company plan to cover young adults until age 28. Does the new federal rule change the state rule? Submitted by Matt, OK
No. Coverage up to age 26 is only a minimum. State rules and individual insurance providers can still extend dependent coverage beyond age 26 – however, often times the state laws will be more restrictive as to who qualifies. (In other words, plans may only be required to cover students or financial dependents who are 26 or older.)
Must insurance providers cover young people who live in a different state than their parents? Submitted by Jessie, AL
Yes. In the definition of "dependent", it does not matter what state a child or her parents live in. However, you should notify your employees that even though it is possible to cover their adult children living out of state, it might not be practical if the plan’s network does not provide access to doctors and hospitals in the state that their child is living in.
Will my company pay higher premiums to cover the adult children of my employees? Submitted by Jen, CA
Under employer plans, the employee typically pays a share of the premium and the employer pays the rest, so premiums will go up for both. However, costs are not expected to rise much. The Office of Management and Budget estimates they will increase by no more than 1 percent.
Does the new coverage expansion apply to dental and vision benefits as well? Submitted by Aaron, NY
No, dependent coverage for dental and vision benefits, if separate from the medical insurance plans, is not included in the new law. You may however voluntarily expand the age for dependents to receive those benefits.
My employee has a 25 year old son who is married and has a child. Must insurance providers cover the children of the adult dependents of their employees? Submitted by Michael, WI
Probably not. Insurance plans are not required to cover the child of an adult dependent of an employee.
My employee's son has his own job that provides insurance. Does he still qualify for our insurance plan? Submitted by Bryan, TN
That depends. If your company plan is a “grandfathered plan” meaning it hasn’t changed significantly since the passage of the new law, then the plan does not have to cover young adults with their own offer of employer sponsored insurance. However, all plans that do not meet grandfathered plan status must cover adult dependents regardless of their health insurance coverage status. Check with your insurance broker or plan administrator to find out the rules about grandfathered plans.
Will plans cover married children of employees? Submitted by Jeff, VA
Yes insurance providers must cover young adults up until the age of 26 whether or not they are married.
Am I required to notify my employees about the dependent coverage provision? Submitted by Kyla, FL
Yes. All plans must notify their employees about the opportunity to enroll their adult dependents. You should make sure your Human Resources administrators or benefits administrators are familiar with the new rules and send notice to employees about the opportunity to cover their adult children. Notice may be included with other plan materials sent to employees during the open enrollment period.