Governor Paterson has signed a law that revises New York State Insurance Law section 3221 to require a commercial insurer, which provides a group health insurance policy to an employer, to offer an election to an employee under that policy to continue the health care coverage of his or her dependent children who have otherwise “aged off” of the coverage. These children may continue to be covered under the group policy through age 29, as long as they do not become eligible for other employer sponsored health insurance coverage, and are not covered by Medicare. The children need not be financially dependent on their parents to receive this coverage. For purposes of the new law, a “dependent child’ is any child of an employee who is unmarried and is under age 30.
Under the new law, an electing employee pays the full cost of the continued coverage for his or her dependent children. The election to receive this coverage must be made: (1) within 60 days following the date the child’s coverage would otherwise terminate due to age, under the terms of the policy covering the employee; (2) within 60 days after meeting the definition of “dependent child” , if coverage previously terminated; or (3) during an annual 30-day open enrollment period. Dependent children, whose coverage terminated prior to the effective date of the new law, will have a period of 12 months after the effective date to elect coverage under the new law.
The new law also requires a not-for-profit corporation or a health maintenance organization (an “HMO”), which offers a group contract or a group remittance contract that is subject to New York State insurance law, to include an election to cover dependent children through age 29 under the same terms and conditions as a commercial insurer.
The new law will take effect on September 1, 2009, and applies to all policies and contracts issued, renewed, modified, altered or amended on or after that date.
Note to Employers: It appears that the insurer, not the employer, is responsible for providing the election to employees required by the new law. Still, an employer providing health care coverage through a group health insurance policy, which is subject to New York State insurance law, should consider coordinating with its insurer and revising its employee notices, election forms and summary plan descriptions to make this election available to its employees.