In Connecticut, the median woman gets married five months after she turns 26.
If she hates her company”™s health insurance plan, she may want to wait a few months more.
Beginning next January, a new Connecticut law will allow parents to continue to cover unmarried children through age 26 under a family”™s health insurance plan, whether an individual policy or through an employer.
To be eligible, the insured person must live in Connecticut if between the ages of 19 and 26, save those who are full-time students in collegiate or graduate programs.
Insurance carriers are allowed to enroll employees in October, a popular month for benefit plans that turn over on Jan. 1. The Connecticut Insurance Department is pressuring carriers to designate no later than December as the open enrollment period for the new law, but indicated many insurers are planning to do so in January.
Health plans are not required to cover dependent children in Connecticut. If they do offer coverage, however, then the state kicks in several additional mandates. Those mandates include providing coverage for adopted children, and now extending coverage to dependents as old as 26.
The law does not apply to companies that self-insure their employees.
Young people who were “aged off” their parents”™ plan under the previous age limit of 23 will be allowed to re-enroll, with carriers required to give them at least one month”™s notice to do so. The law even allows young professionals to drop their current employer”™s plan in favor of a parent”™s plan.
As the case with the current law, young people who age off the new plan can continue benefits under federal COBRA rules, footing premium payments themselves.
The immediate question is whether carriers will change rates or availability of group coverage under the new rules, in turn impacting businesses. Younger people are typically considered attractive for health plans, due to their more infrequent doctor”™s and hospital visits.
While the state insurance department indicated it is receiving inquiries on the new age caps, a local human resources expert said he has not heard a lot of noise yet in Fairfield County, and for good reason.
“The number of companies affected and specifically the number of participants in this age range is minimal, and with minimal direct impact on plans,” said David Lewis, CEO of Stamford-based Operations Inc. “That being said, I expect it will become slightly more of an issue if the economy and job market continues to falter.”
As open enrollment season kicks off next month at many businesses, the Connecticut Insurance Department advises employees to double-check their coverage, particularly if they were married, had a child or packed a child off to college in the past year.
Benefit plan members should also review copayment and deductible policy changes, and whether the health centers they frequent and the insurance carrier still accept each other”™s services.
Lewis advises companies to look carefully at what they are spending now versus what they could spend in the worst case scenario ”“ everyone on a plan spending all their deductibles. Most typically, employees spend about 70 percent of their deductibles, he added.
“Health-savings accounts and health-reimbursement accounts are going to be pushed even more heavily this year than in past years, and rightfully so,” Lewis said. “These plan designs are ”¦ the way most businesses will stem the tide of double-digit employee benefit inflation.”
