Frequently Asked QuestionsExtending health coverage to dependents to age 26

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

2. May an adult child be added to his or her parents’ coverage if he or she is married?

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

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

5. Does the coverage to 26 provision of health care reform apply to “grandfathered plans”?

6. Does this provision apply to groups with “dependents to 30”?

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

2. May an adult child be added to his or her parents’ coverage if he or she is married?
Yes. The provision applies to married and unmarried children.

3. Will a child automatically stay on his or her parents’ policy up to age 26?
Yes. Employers that offer dependent coverage are required to keep adult children enrolled until they turn 26.

4. Do adult children need to be full-time students to be covered to age 26?
No. Eligibility for children up to age 26 exists regardless of their student status.

5. Does the coverage to 26 provision of health care reform apply to “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.

6. Does this provision apply to groups with “dependents to 30”?
No. Members enrolled in a group with dependents to 30 are enrolled as an Individual contract.