When will PEBP begin coverage of children up to age 26?
H.R. 3590, The Patient Protection and Affordable Care Act was signed by President Obama (enacted) on March 23, 2010. Section 1001 of the act requires that, if a plan covers children, that coverage must be available to children up to their 26th birthday. Section 1004 says that section 1001 is effective on the plan year beginning on or after the date of enactment of the Act (September 23, 2010). For PEBP, the first plan year after this date begins July 1, 2011. Many private insurers have elected to begin coverage for adult children immediately for marketing purposes. However, PEBP rates for the plan year beginning July 1, 2010 were set on March 11, 2010, prior to enactment of the Affordable Care Act. It is estimated that the annual cost to cover adult children up to age 26 is approximately $2.8 million to $4.2 million for the self funded PPO plan. Therefore, early coverage of adult children through age 26 would cause a deficit that would be paid for by participants in the next plan year.
Related Questions
- Coverage for Dependents Q701. When do the new requirements regarding the extension of coverage for children under age 26 become effective?
- Does the new extension of dependent coverage to age 26 extend to the children of parents on military health insurance (Tri-Care)?
- Does the provision for coverage of dependents up to age 26 include their children or spouses?
