The Changing Definition of 'Dependent'
Who is Insured and For How long?

The U.S. Census Bureau counts 46.6 million people without health insurance. This number does not include people over the age of 65, who receive Medicare benefits, nor does it take into account the millions more who are inadequately--or "under"--insured. The uninsured population is growing at a staggering rate. In 2000, just under 40 million people did not have health care coverage; in just five years, the population has jumped 6.6 million. Nearly half of this increase is due to young people between the ages of 19 and 34. Employment statistics suggest that fewer employers are offering health care coverage, and more people are self-employed than they were a decade ago.

In an attempt to directly address the fastest growing uninsured population (young adults), state lawmakers are proposing and enacting legislation that extends dependent benefits to older children. Typically, children lose health care coverage under a parent or other legal caregiver on their 19th birthday. Full-time students are often given an exception with dependent status ending at graduation or a specified age. States have addressed specific populations within this age group as well, ensuring that students who take a leave of absence from school due to illness, injury, or service in the armed forces do not lose their health insurance.

Recent sweeping legislation has affected the entire age group in some states. In Utah, for example, a dependent may not age-out of health care coverage until their 26th birthday, regardless of whether or not they are enrolled in school. And in January of 2006, New Jersey enacted a law that provides coverage for dependents until their 30th birthday, as long as they have no dependents of their own. At least four sates also recognize grandchildren as dependents (see chart).

For more information about the Effect of the Working Families Tax Relief Act of 2004 on Employer-Provided Accident or Health Plans Internal Revenue Bulletin: 2004-49, Notice 2004-79 (December 6, 2004) click here

Updated Feb., 2008

State

Laws

California

West's Ann.Cal.Ins.Code § 10277( formerly A.B. 910) requires a health services plan and a health insurer to provide that coverage of a dependent child that is incapable of self-sustaining employment is not terminated at an age limit.

Colorado

Colo. Rev. Stat. § 10-16-104.3 (formerly HB 1101) states that a child is considered a dependent for insurance purposes until their 25th birthday (even if they are not enrolled in an educational institution) as long as they are unmarried, financially dependent, or share the same permanent address as the insurance provider. Effective Jan. 1, 2006 more information

Connecticut

C.G.S.A. § 38a-497 (Formerly S.B. 1484) -This act requires that group comprehensive and health insurance policies extend coverage to children until the age of 26. Bill Analysis Effective January 1, 2009

Delaware

18 Del.C. § 3570 (Formerly H.B. 446) - Requires insurance providers to cover policyholder's dependent children until age 24. Dependents must be residents of Delaware or, if living outside the state, unmarried, must be full-time students. Insurance companies may charge more for dependent coverage past age 18, but it may not exceed 102 percent of the policyholder's cost before the child turned 18.

Florida
Florida 627.6562   Allows for children up to 25 years old who are unmarried and either live in parent's residence or financially dependent on parents to remain on their parents' insurance.

Idaho

Idaho Stat. § 41-2103 (Formerly S.B. 1105) Allows for any unmarried non-students to remain on their parents' insurance until age 21; any full-time, unmarried student until age 25; also allows for those dependent on their parents for medical care to be covered as well.

Indiana

IC 27-8-10-5.1 (Formerly H.B. 1678 ) requires commercial health insurers and health maintenance organizations to cover those who are less the age of 24.

Illinois

5 ILCS 375/3 and 820 ILCS 320/10 (Public Act No. 94-32) Relates to members of the United States Armed Services (including the Illinois National Guard); states that dependents called to active duty between the ages of 19 and 23 shall remain a dependent (as long as they are a full-time student) after their 23rd birthday for the amount of time they spent serving. Cut-off age: 25 (formerly H.B. 116).

Maine

Chapter No. 33 2741-A states that a same-sex partner must be eligible for coverage in the same manner as a spouse, regardless of financial dependency on the insurance provider.

Sec. 1. 24-A MRSA § 2742-A - Requires insurance companies to cover dependent children until age 24 if they have a mental or physical disability which prevents them from being enrolled (or continuing to enroll) in postsecondary education. Passed 4/4/2006. Amended (5/14/07) (Public Law No. 532), changes dependent age to 25.

Chapter 115 Title 24-A § Sec. 1. 24-A MRSA §2742-B (Formerly L.D. 841) Requires individual and group health insurance policies to continue coverage for a dependent child up to 25 years of age if the child is dependent upon the policyholder and the child has no dependents of the his/her own.

Maryland

MD Code, Insurance § 15-418. - (Formerly H.B. 1057) - Requires that health insurance be extended to, at the request of the policy holder, those that are unmarried, under the age of 25 and living with their parents.

Chapter 395 - (Formerly H.B. 1405) - States that an insurer who provides coverage to dependents 18 or older who are enrolled in higher education full-time may not cut off coverage to dependents of the same age if they are only in school part-time due to a documented disability.

Massachusetts

Chapter 58 of the Acts of 2006. (Formerly H.B. 4850) - Health Care Access and Affordability; comprehensive health care reform that includes a dependent status component. Dependents may now stay on their parent's coverage for two years past the age of dependency, or until age 25, whichever occurs first. Young adults ages 19-26 will be eligible for lower-cost insurance coverage, tailored to meet their needs, offered through the Commonwealth Health Insurance Connector. Reform summary and fact sheet, PowerPoint presentation;  More information.

Michigan

M.C.L.A. 550.1409a - (Public Act No. 538) - Requires any insurance policy that covers a dependent while they are enrolled in school (either full or part-time) must continue to cover that dependent for up to 12 months if they take a leave of absence from school due to injury or illness. If the student ages-out of the policy during the 12 month period, the insurance is terminated (Similar to Public Act No. 537). Effective January 1, 2007.

Minnesota

Minnesota Chapter 62E.02 Defines "dependent" as a spouse or unmarried child under the age of 25, or a dependent child of any age who is disabled. Applies to coverage offered, sold, issued, or renewed on or after effective date January 1, 2008.

Missouri
Section 354-536 Continuation of dependent child coverage States if a health maintenance organization plan provides that coverage of a dependent child terminates upon attainment of the limiting age for dependent children, such coverage shall continue while the child is and continues to be both incapable of self-sustaining employment by reason of mental or physical handicap and chiefly dependent upon the enrollee for support and maintenance. A dependent child is a person who is unmarried and no more than twenty-five years of age.

Montana
MCA 33-22-140. (Formerly SB 419) Provides insurance coverage under a parent's policy for unmarried children under 25 years of age.

New Hampshire N.H. Rev. Stat § 420-B:8-aa (Formerly H.B. 790, Companion S.B.183) Expands the definition of dependent young adults to those who are unmarried and less than 26 years of age for purposes of health insurance coverage.

New Jersey

N.J.S.A. 17B:27-30.5 (Formerly A.B. 3759) - states that, at the option of the insured person, a dependent may be covered up to the age of 30, as long as they have no dependents of their own. The insurance provider may charge a higher rate for this coverage, but the increase is not to exceed 3 percent of the premiums.    Read statement.

New Mexico

NM Stat. Ann. § 13-7-8--(2003) (formerly HB 335) states that health insurance for dependents may not be terminated based on age before their 25th birthday, regardless of whether the dependent is enrolled in an educational institution.

Oregon

O.R.S. 291.055, 735.700 (Formerly H.B. 2064 )- Revises the current statute's definition of dependent to include elderly parents and disabled adult children. These dependents are eligible for coverage.

Pennsylvania

51 Pa.C.S.A. § 7309 (Formerly S.B. 869) - Relates to military personnel; states that full-time students whose studies are interrupted by service in the reserves or the National Guard must be extended health care benefits as a dependent of their parent until they finish school, regardless of their age.

Rhode Island

Gen.Laws 1956, § 27-20-45 and Gen.Laws 1956, § 27-41-61 (Formerly S.B. 2211) - Insurance plans which cover dependent children must cover unmarried dependent children until age 19 or, if students are financially dependent, until age 25. If the dependent child is mentally or physically impaired, the plan must continue their coverage after the specified age.

South Dakota

SD Codified Laws Ann. § 3-12A-1(formerly HB 1045) states that any insurance provider offering benefits to a dependent may not terminate those benefits by reason of age before the dependent's 19th birthday. If the dependent is enrolled in an educational institution, they are not to be terminated until they reach the age of 24 (in a calendar year).

SD Codified Laws § 58-17-2.3 (2007) (formerly S.B. 108) states that no insurer or health carrier issuing a health benefit plan that provides dependent coverage for any qualifying child may terminate coverage due to attainment of a limiting age below age nineteen, or, if a full-time student in an accredited institution of higher learning below age twenty- four. If the dependent remains a full-time student upon attaining the age of twenty-four but not exceeding the age of twenty-nine, the insurer shall provide for the continuation of coverage for that dependent at the insured's option. Nothing in this Act requires the employer to contribute any portion of the premium for dependents that are full-time students and have attained the age of twenty-four.

Texas

V.T.C.A., Insurance Code § 846.260 and V.T.C.A., Insurance Code § 1201.059 (Formerly HB 1446 / companion bill SB 927) makes dependent status available for until they are 25 years, not married, and a dependent of the insured for federal income tax purposes at the time the application for coverage

Utah

Utah Code Ann. § Title 31A Chapter No. 22-610.5 Requires that coverage for unmarried dependents continue until the dependent's 26th birthday, regardless of whether or not the dependent is enrolled in higher education.

  Vermont

Sec. 1. 8 Vermont Statute Ann. § 4089d - States that if an insurance company covers dependents after the age of 18, they must continue coverage for a dependent's medically necessary leave of absence from school for up to 24 months. Law also states that if a dependent is mentally or physically incapable of self-sustaining employment and chiefly dependent on the policyholder, they must not be dropped from the plan once they reach the limiting age.

Virginia
Va. Code Ann. § 38.2-3323 makes dependent status available to any child who is under the age of nineteen years or who is a dependent and a full-time student under twenty-five years of age.   Va. Code Ann. § 51.1-512.1 (Formerly H.B. 1622) Requires that coverage under a health insurance policy for a dependent child who is enrolled as a full-time student shall continue in force for up to 12 months from the date the child ceases to be a full-time student if the child is unable to continue as a full-time student due to a medical condition. The child's treating physician must certify when the child withdraws from school that the absence is medically necessary. The measure applies only to covered children under age 25.

Washington

West's RCWA 48.44.215 (Formerly S.B. 5930) Based on the Blue ribbon Commission on Health Care Cost and Access. States that, at the option of the insured person, a dependent may be covered up to the age of 25.

COBRA Continuation Coverage Rights:
A dependent child will become qualified for COBRA benefits if they lose coverage under their parent's employer-sponsored insurance (20 employees or more) if:

1. the parent/employee dies
2. the parent/employee's hours of employment are reduced;
3. the parent-employee's employment ends for any reason other than his/her gross misconduct;
4. the parent/employee becomes enrolled in Medicare
5. the parents become divorced or legally separated; or
6. the child stops being eligible for coverage under the plan as a "dependent child"

COBRA continuation coverage is a temporary continuation of coverage. For #6 the period of coverage is 36 months. Beneficiaries typically pay the entire premium for coverage (employer and employee share). The premium charged to the beneficiary cannot exceed 102 percent of the cost of the plan for similarly situated individuals who have not incurred a qualifying event.

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The Changing Definition of 'Dependent'Who is Insured and For How long?

The Changing Definition of 'Dependent'
Who is Insured and For How long?