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Healthcare Reform: Rules Regarding Adult Children and Health Insurance Finally Issued

In the first of what is sure to be a steady stream of rules and regulations regarding healthcare reform, rules for adding adult children to a parent’s health insurance policy have finally been issued by the White House this week.

Under the healthcare reform bill which was signed by President Obama, both employer-based health insurance policies and individually issued health insurance policies must allow policyholders’ adult children to be on a parent’s health insurance policy until the age of 26. However, until now, it has been unclear what restrictions and qualifications may apply in such cases, and health insurance companies have been at a loss when policyholders have asked what they do in order to add their children to their health insurance.

Well, now we finally have some answers. And the answer is yes, employer-based health insurance plans and health insurers which issue individual insurance policies must offer health insurance coverage to a member’s children up to the age of 26, regardless of whether the child lives with the parent, is a full-time student, is married or unmarried, is a dependent for income-tax purposes, or receives financial support from the parents.

In addition, health insurers and employers must offer a 30-day period during which adult children can be enrolled under a parent’s health insurance, and terms (such as premiums) cannot vary based on an adult child’s age, i.e. insurers cannot charge a surcharge for on adult children who are between 19 and 25.

The rules do allow a limited exception for employer-based health insurance plans that were already in existence on March 23rd when President Obama signed the healthcare reform bill. Those health insurance plans are not required to offer coverage to a member’s adult child until 2014 if the child has access to health insurance through another employer-based health insurance plan. Of course, this is most likely to occur if the adult child works for an employer that offers its own employer-based health insurance plan.

The requirement to offer health insurance coverage to adult children does not take effect until September of this year, but many health insurance companies including Wellpoint (parent company for Anthem Blue Cross and others), Humana and United Healthcare have already agreed to extend insurance coverage for adult children immediately so they do not have to wait out a gap in their health insurance.

On Monday, the Obama Administration urged employers to follow the health insurers’ example and extend health insurance coverage for their employees’ adult children.

We do note however, that ironically, the federal government has already announced that it will not be able to extend health insurance coverage to the adult children of federal employees in the Federal Employees Health Benefits program until next year.

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Related posts:

  1. Healthcare Reform: Wellpoint (Anthem Blue Cross) to Extend Health Insurance Coverage to Adult Children on June 1
  2. Healthcare Reform: United Healthcare and Humana Join Wellpoint (Anthem Blue Cross) in Extending Health Insurance to Adult Children
  3. Healthcare Reform Changes: Health Insurance and Adult Children
  4. Healthcare Reform: Putting your Adult Child on Your Health Insurance Policy… Is It Worth It?
  5. Healthcare Reform: No Surprise, Health Insurance Companies Fight Covering Children with Pre-Existing Conditions

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