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Dependent Health Coverage State Implementation

Covering Young Adults Through Their Parents' or Guardians' Health Policy

Are you a parent or young adult seeking more information on health insurance coverage provisions for young adults in the Affordable Care Act? Read the White House's answers to the most frequently asked questions and a White House fact sheet on the topic.   Also read the Department of Labor's answers to frequently asked questions for additional information on the details of coverage for young adults. If you have specific questions about health insurance coverage for young adults discuss them with your employer's benefits manager or contact your state's department of insurance.

For information on state laws implemented prior to federal reform, click here

September 23, 2010Girl on Computer
Approximately 30 percent of Americans between the ages of 19 and 29 have no health insurance. This age group makes up 13 million of the 47 million Americans currently living without health insurance. The Affordable Care Act allows young adults to remain on their parents' or guardians' health plan until age 26. The U.S. Department of Health and Human Services estimates that approximately 2.37 million young adults will be affected by the new law, out of which 1.83 million are currently uninsured.

  • What is required and who is responsible?

The Patient Protection and Affordable Care Act extends health care coverage for young adult children under their parent's health plan up to the age of 26.

The Affordable Care Act requires plans and issuers that offer coverage to children on their parents’ plan to make the coverage available until the adult child reaches the age of 26. The issued regulations state that young adults are eligible for this coverage regardless of any, or a combination of any, of the following factors: financial dependency, residency with parent, student status, employment and marital status. This applies to all plans in the individual market and to employer plans created after the date of enactment (March 23, 2010). For employer plans that were in existence prior to the date of enactment, young adults can qualify for dependent coverage only if they are not eligible for an employment-based health insurance plan until 2014. Beginning in 2014, young adults can choose to stay on their parent’s health plan until age 26, even if they are eligible for their own employer-sponsored insurance plan.

This law does not require that a plan or issuer offer dependent coverage but that if coverage is offered it must be extended to young adults up to age 26.   

What is the state role?

The new law will apply in all states. States may continue with current state law requirements for extended dependent coverage unless they prevent the application of the Patient Protection and Affordable Care Act. State and local governments, as sponsors of coverage plans, will be required to notify those under the age of 26 whose coverage has ended or who were denied coverage under their plans before turning 26, of enrollment opportunities. 

When will it happen?

Coverage for young adults up to age 26 became effective on Sept. 23, 2010.  

What will it cost and who will pay?

The cost of notifying families about new enrollment opportunities will be shared between insurance providers and employers. The cost of covering the young adults who take advantage of the extension will be shared between employers and the families of newly covered young adults. States, as sponsors of coverage plans for state employees, will also share the costs with families. The qualified young adult cannot be required to pay more for coverage than similarly situated individuals who did not lose coverage due to the loss of dependent status.

IRS Notice 2010-38 provides guidance to extend the general exclusion from gross income for the reimbursements for medical care under an employer provided accident or health plan to any employee's child who has not yet attained age 27 as of the end of the taxable year--making the benefit tax-free.

HHS News Release - New health care law helps more than 3 million young adults get and keep health coverage, June 19, 2012

NCSL Fact Sheet

White House Press Release

White House Fact Sheet

IRS Press Release

Commonwealth Fund:  Rite of Passage:Young Adults and the Affordable Care Act of 2010

Kaiser Family Foundation Summary

State Actions

The new federal law applies to young adults in all states. 

As of June 2010, the following 37 states extended the age that young adults can remain on their parents' health insurance plan:  Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming

There is considerable variation among state laws in terms of eligibility requirements. At least 30 states have extended dependent coverage, regardless of student status. Most states require that a young adult be unmarried and financially dependent on their parents in order to qualify for extended dependent coverage. States may continue to apply current state law requirements for extended dependent coverage except to the extent that the requirements prevent the application of the Patient Protection and Affordable Care Act.

Table of State Laws

State                     

Laws

Colorado

Colo. Rev. Stat. § 10-16-104.3 states that a child is considered a dependent for insurance purposes up to age 25 (even if they are not enrolled in an educational institution) as long as they are unmarried and are financially dependent or share the same permanent address as the insurance provider.

Connecticut

C.G.S.A. § 38a-497 requires that group comprehensive and health insurance policies extend coverage to unwed children until the age of 26 provided they remain residents of Connecticut or are full-time students.

Delaware

Del. Code Ann. Tit. 18, § 3354 requires insurance providers to cover policyholder's dependent children until age 24. Dependents must be unmarried and a resident of Delaware or, if living outside the state, a 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 dependent children up to 25, who live with their parent or are a student, and up to 30 years old, who are also unmarried and have no dependent child of their own, to remain on their parents' insurance.

Georgia

Ga. Code § 33-30-4 allows dependent children up to age 25 who are enrolled as a full-time student at least five months during the year or are eligible to enroll but are prevented due to illness or injury to remain on their parents' insurance.

Ga. Code § 33-24-28 requires that a health services plan or health insurer exempt dependent children incapable of self-sustaining employment due to disability from dependent age limits. 

Idaho

Idaho Stat. § 41-2103 allows for any unmarried dependents to remain on their parents' health insurance until age 21; any full-time, unmarried student until age 25; or a dependent with a disability without regard to age.

Illinois

215 ILCS 5/356z.12 provides parents with the option of keeping unmarried dependents on their health care insurance up to age 26. Parents with dependents who are veterans can keep them on their plans up to age 30.

Indiana

IC 27-8-5-2,28 and  IC 27-13-7-3 require commercial health insurers and health maintenance organizations to cover children until age of 24 or without regard to age if they are incapable of self-sustaining employment due to disability.

Iowa

Iowa Code § 509.3 and Iowa Code § 514E.7 requires that health insurance providers continue to cover unmarried children under their parents' coverage provided that the child 1) is under the age of 25 and a current resident of Iowa, 2) is a full-time student, or 3) has a disability.

Kentucky

Ky. Rev. Stat. § 304.17A-256 allows parents to keep their unmarried children on their health plans until the age of 25. Parents may have to pay extra for their adult children.

Louisiana

La. Rev. Stat. Ann. § 22:1003 allows an unmarried, dependent child to remain on parent's insurance up to age 24 if they are a full-time student.

Maine

24-A MRSA § 2742-B 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 requires that health insurance be extended to, at the request of the policy holder, unmarried dependents under the age of 25. 

Massachusetts

Mass. Gen. Laws Ann. Ch. 175 § 108 allows dependents to stay on their parent's coverage for two years past the age of dependency or until age 26, whichever occurs first, or without regard to age if they are incapable of self-sustaining employment due to disability.

Young adults ages 19-26 are 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.

Minnesota

Minnesota Chapter 62E.02 Defines "dependent" as a spouse or unmarried child under age 25, or a dependent child of any age who is disabled.

Missouri

Mo. Rev. Stat. § 354-536 defines dependent as an unmarried child up to age 26. 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.

Montana

MCA 33-22-140 provides insurance coverage under a parent's policy for unmarried children up to age 25.

Nevada

NRS 689C.055 allows an unmarried, dependent child who is a full-time student to remain on his or her parent's insurance up to age 24 if parent is covered by small group policy.

NRS 689B.035 requires that dependents retain coverage beyond age of policy termination if they are incapable of self-sustaining employment due to disability.

New Hampshire

N.H. Rev. Stat § 420-B:8-aa defines dependent as those who are unmarried up to age 26 and either a full-time student or resident of New Hampshire for purposes of health insurance coverage.

2009 SB 115 allows those up to age 26 to buy-in to coverage through the state's CHIP program, Healthy Kids.

New Jersey 

N.J.S.A. 17B:27-30.5 states that, at the option of the insured person, a dependent may be covered up to the age of 31, as long as they are unmarried and have no dependents of their own.

New Mexico

NM Stat. Ann. § 13-7-8 states that health insurance for dependents may not be terminated based on age up to age 25. 

New York

2009 AB 9038 allows an unmarried child to remain on parent's insurance up to age 30 if they are a resident of New York.

North Dakota

N.D. Cent. Code § 26.1-36-22 allows an unmarried, dependent child to remain on parent's insurance up to age 22 if they live with parents. If they are a full-time student, they can remain on parent's insurance from age 22 up to age 26.

Ohio

Ohio Rev. Code § 1751.14, as amended by 2009 OH H 1 allows an unmarried, dependent child that is an Ohio resident or a full-time student to remain on parent's insurance up to age 28, or without regard to age if they are incapable of self-sustaining employment due to disability.

Oregon

O.R.S. § 735.720 defines dependent as an unmarried child up to 23, elderly parents and disabled adult children for the purpose of insurance coverage.

Pennsylvania 

2009 SB 189 states that an unmarried child may remain on parent's insurance up to age 30 if they have no dependents and are residents of PA or are enrolled as full-time students.

51 Pa.C.S.A. § 7309 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 beyond the terminating age equal to the length of their deployment..

Rhode Island

R.I. Gen. Laws § 27-20-45 and Gen. Laws § 27-41-61 requires insurance plans which cover dependent children to cover unmarried dependent children until age 19 or, if a student, until age 25. If the dependent child is mentally or physically impaired, the plan must continue their coverage after the specified age. 

South Carolina

S.C. Code Ann. § 38-71-1330 allows an unmarried, dependent child who is a full-time student to remain on parent's insurance up to age 22 if parent is covered by small group policy.

S.C. Code Ann. § 38-71-350 requires that a dependent child who is not capable of self-sustaining employment be allowed to remain on his or her parent's insurance, without regard to age.

South Dakota

SD Codified Laws Ann. § 3-12A-1 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 age 24 and not terminated if unable to seek self-support due to disability.

SD Codified Laws § 58-17-2.3 states that if the dependent remains a full-time student upon attaining age 24 but not exceeding age 29, the insurer shall provide for the continuation of coverage for that dependent at the insured's option.

Tennessee

Tennessee Code Ann. § 56-7-2302 allows for dependent coverage for children under their parents' health insurance plan up to age 24 provided the child is unmarried and financially dependent on the parents.

Texas

V.T.C.A. Insurance Code § 846.260 and V.T.C.A. Insurance Code § 1201.059 make dependent status available for an unmarried child up to age 25 for insurance purposes.

Utah

Utah Code Ann. tit. 31A § 22-610.5 requires that coverage for unmarried dependents continue up to age 26, regardless of whether or not the dependent is enrolled in higher education. 

Virginia

Va. Code Ann. § 38.2-3525 makes dependent status available to any child up to age 19 or who is a dependent up to age 25 who resides with the parent or is a full-time student.

Washington

West's RCWA 48.44.215 states that, at the option of the insured person, an unmarried dependent may be covered up to age 25.

West Virginia

W. Va. Code § 33-16-1a defines dependent for health insurance coverage as a child or stepchild up to age 25.

Wisconsin

Wis. Stat. § 632.885 requires that coverage for unmarried dependents through a parent's insurance be offered up to age 27 if they are not offered insurance through an employer. Full-time students called to active duty in the armed forces can be covered beyond age 26 depending on various factors.

Wyoming

Wyo. Stat. § 26-19-302 states that if child is unmarried and a full-time student, they can remain on parent's insurance up to age 23 if parent is covered by small group policy.

Source: State Health Facts and NCSL, 2009.

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