New college grads could lose health care coverage, despite new laws


Issue:

An employee whose 24-year-old daughter is graduating from college in May 2010 has asked you whether she can keep her daughter on her employer-provided health plan now that health care reform has passed. Although your plan caps dependent coverage at age 24 if the dependent remains a full-time student, the employee tells you that she heard the new legislation extends dependent coverage up to age 26 whether or not the dependent is a full-time student. Must the plan continue the daughter’s coverage under the new health care reform laws?

Answer:    

No, because the health care reform provision that the employee mentioned does not take effect right away.

For plan years beginning on or after September 23, 2010, group health plans and health insurance issuers offering group or individual health insurance that provide dependent coverage of children must continue to make health coverage available for an adult child until the child turns 26 years old. Health plans or health insurers are not, however, required to cover a child of the adult child receiving dependent coverage.

The Department of Health and Human Services will issue regulations to define dependent for purposes of this provision. The Internal Revenue Code definition of dependent for tax purposes is not changed.

To address this coverage gap, some insurers are voluntarily offering to continue health insurance for young adults graduating from college or aging out of their parents’ plan prior to the required implementation of the new dependent coverage provision.

Source: Public Health Service Act Sec. 2714, as added by Act Sec. 1001(5) of the Patient Protection and Affordable Care Act (P.L. 111-148), as amended by Act Sec. 2301(b) of the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152).

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