The Overview:
The dependent coverage expansion allows your adult children under age 26 to stay on your employer-provided or private health insurance plan.

• Your children can be covered even if they are married or have a child, but their spouses and children cannot be covered under your plan.
• To qualify for coverage through your plan, adult children must not be eligible for another employer-sponsored insurance plan through their employer or spouse.
• Your adult children are eligible for your health insurance plan whether or not they are a student and regardless of whether they file taxes independently (this is a big change from the previous state laws.)

Your adult children are eligible to enroll on your insurance at the start of your plan's next open enrollment period beginning on or after September 23, 2010. For most employer-based insurance, that will be on January 1, 2011. But it could be later. Talk to your employer about the start date at your workplace.

Insurance providers must provide you, the parent, with written notice of when the start of the next plan year is and inform you that your adult child can enroll within 30 days of the next plan year. WATCH OUT FOR THE NOTICE! This written notice can be given to you along with other standard insurance materials. Be proactive! Ask your employer/provider when the next plan year after September 23, 2010 is so you do not miss the enrollment opportunity.

This is so important it is worth repeating. Adult children will have a 30-day special enrollment opportunity to re-enroll on your insurance. If your children miss this opportunity, they will have to wait until the next open enrollment period. That likely will not be for another year!

Your insurance must charge the same to cover your adult child as they would to cover any younger child. No discrimination allowed.

Some states already have laws that require insurers to go beyond age 26 for dependent coverage. In those states, you will likely be able to cover your child on your plan even beyond their age 26. Find out the laws in your state.

Answer

Your child is guaranteed a 30-day special open enrollment opportunity to enroll on your plan after September 23. For example, if your company has a plan year starting January 1, 2011, the enrollment period will likely be in late Fall 2010. WATCH FOR THE NOTICE. If your child misses this chance they will have to wait until the next open enrollment period, which may not be until the next plan year! Make sure you sign your child up right away!

Answer

That is a decision for you and your child to make after doing some research. Many insurance plans provided to college and university students are expensive, have high deductibles and offer poor coverage. Your insurance plan may well be less expensive and offer better coverage. However, the only way to find this out is to compare the costs and coverage of your child’s college plan and your employer-provided plan and make a decision. Also keep in mind that your plan might not cover or might charge more for care that is not in network, which could happen if your child goes to an out-of-state school.

Answer

Unfortunately, the children of your eligible child cannot enroll on your plan, unless of course your grandchild is your dependent, and not your son/daughter’s dependent.

If your child cannot afford or does not have insurance for your grandchild, you and your child should contact your state’s Child Health Insurance Program (CHIP) to see if your grandchild qualifies for insurance there. Go to HealthCare.gov for more information. Re- member that many states offer free vaccines and flu shots for children under the age of 18. You should check to see if your state has such programs.

Answer

Your child’s spouse is not eligible to enroll on your plan. Hopefully, your child’s spouse can enroll on his/her parents’ plan or through their employer.

Here are 6 wrong reasons for denying coverage that we have been hearing about from around the country.

Reason #1.

Your child cannot join your plan because he/she no longer lives with you.

Wrong. Your child does not need to live with you to be on your plan.

Reason #2.

Your child cannot join your plan because he/she does not live in the same state as you.

Wrong. Your child can live in another state and still be on your plan.

Reason #3.

You cannot enroll your child on your plan because you do not claim him/her as a dependent on your tax return.

Wrong. Your child can file taxes independently and still be on your plan.

Reason #4.

You cannot get your child covered under your insurance because he/she is no longer a full-time or part-time student.

Wrong. Your child does not need to be a student to be on your plan.

Reason #5.

You cannot put a married child on your plan. That is just not possible.

Wrong. Your child can be married and still be on your plan.

Reason #6

Your child cannot be on your insurance because your employer is a “self-insurer” and the law does not apply to them.

Wrong. The law applies to ALL employers offering family coverage, including self-insurers. This is an important change from old state laws.

Right Now

A temporary “high-risk pool” provides insurance for those who were denied coverage due to a pre-existing condition and have been uninsured for more than 6 months. This especially benefits the 15 percent of young Americans who suffer from chronic conditions.

September 23, 2010

Adult children will be able to remain on their parent’s health insurance until their 26th birthday.

Over 2 million previously uninsured young adults will benefit from this provision.

Are you a parent? If your adult child is under 26 and uninsured, talk to your employer now about how they can join your plan!

Health plans no longer able to drop coverage (no “rescission”) when you get sick Lifetime limits on benefits banned.

Restrictive annual limits on benefits banned (all annual limits banned by 2014).

JANUARY 1, 2011

All plans will have to spend at least 80 percent (for small/individual plans) or 85 percent (for large group plans) of premiums on medical services. Those who fail to do so will have to submit rebates to consumers. That means more of your money will be required by law to go to the care you need.

JANUARY 1, 2014

Medicaid will cover every American earning less than 133 percent of the Federal Poverty Level (FPL), about $14,400 per year for an individual. This change alone will provide coverage for over 7 million currently uninsured young adults.

Tax credits will be given for purchasing health insurance to those who earn less than 400 percent FPL (about $43,000 per year for an individual) and lack employer-sponsored insurance.

Health plans will no longer be able to deny coverage based on pre-existing conditions.

JANUARY 1, 2014

All Americans must have health insurance, however the requirement will be waived due to hardship or lack of affordable health insurance.

States will create insurance exchanges to increase market competition and enforce minimum benefit standards. Consumers will be able to compare prices and plans online and choose the best health insurance package for themselves.