Children can remain on Parents’ Health Insurance Policy until age 26

PPACA allows children to stay on their parent’s health insurance plan until they turn 26 years old.  The new law changes the existing definition of dependents allows children to enroll as dependents on their parents’ policy even if the children:

  • Are not financially dependent on their parents for support,
  • Are not claimed as dependents on the parents’ tax return,
  • Are not residents of the parents’ household,
  • Are not enrolled as students; or
  • The children are married and have their own dependents, however children-in-law (spouses of children) and grandchildren are not eligible. “Children” includes natural children, legally adopted children, stepchildren and children who are dependent on the parent during the waiting period before adoption.

Anthem Blue Cross has notified small group employers that they must offer a special enrollment period for dependent children under age 26. Here is an excerpt from Anthem Blue Cross’ notice to California Small Employer Groups:

“Employees who want to add children who are younger than 26 years old to their health plan have a one-time special enrollment right under the law. This enrollment right applies to adult children under 26 who were denied coverage in the past because they exceeded the maximum dependent age, or who were enrolled and lost coverage because they reached the maximum dependent age under your policy. The special enrollment right must last for at least 30 days even if your open enrollment period is less than 30 days.

If the parent is not enrolled in your plan, both the employee and the adult child are eligible to enroll during the special enrollment period. 

If the employee currently has single or employee/spouse coverage and wants to add children, the employee will need to change his or her enrollment status to one that allows dependents to be added to the contract, such as family or employee/children coverage. If the employee requests to add children, the children will be covered upon your health plan’s renewal date.

The special enrollment right must be offered during the first 30 days of your plan year. If you have an open enrollment period that precedes the start of your plan year, you may use the regular open enrollment period as the special enrollment period. If you do not conduct open enrollment periods, you are required to extend the special enrollment right during the first 30 days of your plan year on or after September 23, 2010.

If employees currently have dependents enrolled in your plan and want to continue to cover them, they do not need to do anything.

If employees do not want to keep their children on their plan until age 26, they need to contact their benefits administrator to remove them.”

Fully insured group health insurance plans that renew after September 23, 2010 (i.e., October 1, 2010 renewal dates) must notify employees that they have the right to add children who are under age 26. To be on the safe side, we recommend that an employer notify all employees – regardless of whether they are currently enrolled in the group health plan – that they can enroll a child under the age of 26 as a dependent on the plan. An employee who is not enrolled may choose to enroll to enable an under age 26 child also enroll in the group health plan. Give us a call at BenefitsCafe.com if you have any questions about how your specific insurance company will handle this. We are happy to contact insurance companies on behalf of our clients.