Employment-DOL Provides Guidance On New Rule Requiring A Health Plan To Cover Children To Age 26

The recently enacted health care legislation requires health care plans, which offer dependent coverage, to make the coverage available to an employee’s child, until the child reaches age 26. The Department of Labor (the “DOL”) has now provided guidance on this rule, in the form of regulations, a fact sheet and frequently asked questions (“FAQs”).

Highlights from the FAQs include the following information:

–The extension of dependent coverage for adult children is effective for plan years beginning on or after September 23, 2010. However, the Administration has urged insurance companies and employers to prevent a gap in coverage for young adults aging off of their parents’ plan or policy prior to this effective date. Individuals should check with their insurance company or employer to see if they are offering this coverage.

–For plan years beginning on or after September 23, 2010, health care plans must give children who qualify an opportunity to enroll that continues for at least 30 days (regardless of whether the plan normally offers an open enrollment period). This enrollment opportunity, and a written explanation of the opportunity, must be provided not later than by the first day of the first plan beginning on or after September 23, 2010. Some plans may provide the opportunity at an earlier time. A child who previously lost coverage under his or her parent’s plan due to age, but who is eligible to enroll under the new rule, may enroll during this open enrollment period.

–The new rule extending health care coverage applies to any adult child under age 26, unless the child has another offer of employer-based health care coverage (such as through his or her job). Beginning in 2014, children up to age 26 can stay on their parent’s employer health care plan even, if they have another offer of coverage through an employer. No limitation may be imposed on an adult child’s enrollment in a plan based on his or her financial dependency, marital status, enrollment in school, residency or other similar factor.