Grandfathered Health Plans & Defining Adult Children Under the PPACA

The Patient Protection and Affordable Care Act (PPACA) redefined “dependent” to include adult children to age 26.  The provision became effective September 23, 2010, and except for grandfathered plans, applied to all group and individual health insurance plans.

Defining Adult Children Under the PPACAUnder the new definition of dependent, all adult children to age 26 are considered eligible whether or not they are married, in school, living at home, financially independent, or qualified to enroll in their own employer-sponsored health insurance plan.

To date, there has been one exception:  grandfathered group plans are not required to extend health insurance plans to adult children to age 26IFthey are eligible to enroll in their own employer-sponsored health insurance plan.  This exception for grandfathered health plans, however, will expire in 2014.  After the first renewal date in 2014, grandfathered health plans will be required to extend health insurance to adult children up to 26, regardless of their eligibility to enroll in their own employer-sponsored health insurance plan.

Please be aware of this change as you look toward your 2014 renewal.  Those of you with grandfathered plans may need to consider how including adult children will affect your plan.  Keep  in mind that some carriers may have elected to cover children regardless of their eligibility to enroll in a different employer-sponsored health insurance plan.  If you have questions, please This email address is being protected from spambots. You need JavaScript enabled to view it. for further assistance.