Health Care Reform

Frequently Asked Questions

Extending health coverage to dependents to age 26

1. When is the adult child to age 26 provision of the health care reform law effective?

2. Can an adult child be added to his or her parent’s coverage if he or she is married?

3. Will you provide similar coverage for new members?

4. Will a child automatically stay on his or her parent’s policy up to age 26?

5. Do adult children need to be full-time students to be covered to age 26?

6. Can an adult child who reached the previous maximum age be added back onto his or her parents ’ policy until they reach age 26?

7. When will an adult child be eligible to be added back onto a parent’s policy if his or her eligibility terminated?

8. Does coverage to 26 provision of health care reform apply to the so-called “grandfathered plans”?

1. When is the adult child to age 26 provision of the health care reform law effective?
The provision of the health care reform law for dependent coverage to 26 becomes effective for plan years beginning or after September 23, 2010 and is effective at the group’s anniversary date. This will be applicable to all individual policies and groups regardless of size and whether they are fully or self funded.

2. Can an adult child be added to his or her parent’s coverage if he or she is married?
Yes the provision applies to married and unmarried children.

3. Will you provide similar coverage for new members?
When the new reform law becomes effective on the renewal date of your policy beginning on or after September 23, 2010, all adult children up to age 26 will be eligible for coverage.

4. Will a child automatically stay on his or her parent’s policy up to age 26?
Yes. Once the law goes into effect on or after September 23 employers that offer dependent coverage will be required to keep adult children enrolled until they turn 26.

5. Do adult children need to be full-time students to be covered to age 26?
No. When the reform legislation becomes effective, eligibility for children up to age 26 will be extended regardless of their student status.

6. Can an adult child who reached the previous maximum age be added back onto his or her parents’ policy until they reach age 26?
Yes, adult children who were covered under a fully insured plan, but who lost coverage when he or she graduated from college or reached the maximum age as required under the health plan, can be added back to a parent’s policy upon renewal.

7. When will an adult child be eligible to be added back onto a parent’s policy if his or her eligibility terminated?
When the new reform law becomes effective on the renewal date of your policy beginning on or after September 23, 2010.

8. Does coverage to 26 provision of health care reform apply to the so-called “grandfathered plans”?
Yes. Coverage to 26 applies to all group plans and to individual products. However, for plan years that begin before January 1, 2014, grandfathered plans do not have to provide coverage for adult dependents when the adult dependent is employed and is eligible for coverage through the adult dependents’ employer. For plan years beginning on or after January 1, 2014 all plans, both grandfathered and non-grandfathered, must cover all dependents under 26 even if the dependent is employed and is eligible for coverage through the dependents’ employer.