Dependent children can stay on their parents policy
to  age 26

Employer Groups
Definition of #Dependent

CA Insurance Code §10853

(e) “Dependent” means the spouse or registered domestic partner, or child, of an eligible employee, subject to applicable terms of the health benefit plan covering the employee, and includes dependents of guaranteed association members if the association elects to include dependents under its health coverage at the same time it determines its membership composition pursuant to subdivision (s).

(f) “Eligible employee” means either of the following:

(1) Any permanent employee who is actively engaged on a full-time basis in the conduct of the business of the small employer with a normal workweek of an average of 30 hours per week over the course of a month, in the small employer’s regular place of business, who has met any statutorily authorized applicable waiting period requirements… ^{Legislature.Gov} *

See also the Employer Administrative Manual for the relevant Insurance Company!

When a dependent loses coverage, there is Cal COBRA or Individual Plans.

…Group or individual health insurance coverage that provides dependent coverage of children shall continue to make such coverage available for an adult child  until the child turns 26 years of age.  

College attendance or student status is no longer an issue! ^{((Obama’s Plan SEC. §2714(a). EXTENSION OF DEPENDENT COVERAGE. FACt Sheet  ,  Blue Cross Specimen Individual Policy   * consumer notice   *   Overage Dependent Quick Guide *Regulations & Guidance}   

Definition of Dependent
Internal Revenue Code  IRC §152 

a)”dependent” means any of the following individuals (click here for list)  over half of whose support, for the calendar year in which the taxable year of the taxpayer begins, was received from the taxpayer (or is treated under subsection (c) or (e) as received from the taxpayer): IRS Publication 501  

Our Site on 1040 including instructions  

Insurer’s must notify you, when you lose  dependent status  ^{(AB 910 2007)}

At age 26 check out:

Get FREE CA Quotes under Health Care Reform

COBRA    &  Cal COBRA

Lifetime Coverage for disabled child over 26

FAQ’s

CMS.Gov

UHC

Do Insurance Companies ever audit – check if dependents are really eligible?

Cal Pers drops 18k from Insurance Rolls  CA Health Line 10.21.2015

What about adult children under 26?
For Covered CA Subsidies?

Adult child up to age 26 are eligible for Coverage through their parents employers plan.  However if they are  paying their own taxes, they are not anyone’s tax  dependent, they do not count towards  household income, – MAGI.   Then the adult children could qualify for their own coverage in Covered CA.

In some cases, it might be an idea to exclude dependents from coverage on a group plan, so that the spouse and children can qualify for Covered CA subsidies.  Thus avoiding the the Family Glitch?

Learn More⇒

• Kaiser Health News 11.8.2013
• Our Webpage on the Family Glitch?
• Health Insurance Order 

When, How to add #Newborn Coverage? 
What is 30 days of Coverage?

Here’s excerpts of a sample Individual ACA Health Reform Compliant Policy:

Newborns are covered during the first thirty-one (31) days from birth and Adopted Children are covered during the first thirty-one (31) days from the date the Subscriber, enrolled spouse, or enrolled Domestic Partner is granted the right to control health care for an Adopted Child.   Refer to the part YOUR ELIGIBILITY for additional information about coverage of Newborns and Adopted Children ^{Specimen Policy Page 20}

Newborn and Adopted Child Coverage Newborn and adopted child(ren) of the Subscriber or the Subscriber’s spouse will be covered for an initial period of sixty (60) days from the date of birth or adoption. Coverage for Newborn and adopted child(ren) will continue beyond the sixty (60) days, provided the Subscriber submits through us a form to add the child under the Subscriber’s Agreement. The form must be submitted along with the additional Premium, if applicable, within sixty (60) days after the birth of the child. Failure to notify us and pay any applicable Premium during this sixty (60) day period will result in no coverage for the Newborn or Adopted Child beyond the first sixty (60) days ^{Specimen Policy Page 26}

Newborn is a recently born infant within thirty-one (31) days of birth. ^{Specimen Policy Page 168} *

As long as you enroll your newborn within 30 days of birth, coverage should be effective as of your baby’s birth date, and your baby cannot be subject to a preexisting condition exclusion.

Remember, you should enroll your baby within 30 days of the date of birth. ^DOL.Gov

See rules for Special Enrollment for Individual Plans.

Why was I billed for my newborn’s charges?

No insurance will add your newborn automatically. It is your responsibility to inform your insurance company to add your newborn baby. Most insurance companies will give you 30 days after the arrival of your newborn to add them to your coverage. However, not all plans will retro your coverage back to the birth. Always check with your insurance company for their requirements. ^{sjmedicalgroup.com}

Report Changes in household within 30 days to Covered CA  Publication 5152

Forum says the rules above stand… just because insurance company gave a month of coverage, no obligation to extend period to add child.

Consumer Links

Specimen Health Reform Individual Platinum Policy – Eligible Dependents Page 25

CMS  FAQ’s

Regulations & Guidance

California Insurance Company Forms & Applications

Anthem Blue Cross 9/1/2010 Bulletin

UHC Group Policy Extract

HealthCare.Gov     White House.Gov   Affordable Health Care Act   YouTube Channel

Right of Non Custodial Parent to Obtain Medical Information  (Family Law Code 3751.5)

Historical Links

Covered CA problems with implementing the law.

Blue Cross FAQ’s 4/30/2010

LA Times 4/4/2010 Article

One time Open Enrollment November 2010

Blue Cross Anthem Open Enrollment November for January 1 Effective Date Application – Change Form

• Commercial health plans and insurers are prohibited from terminating coverage for full-time dependent students over 18 during a break in the school calendar or a medically necessary academic leave of absence.
• Coverage continues for up to one year or until coverage is scheduled to terminate under the plan’s terms and conditions, whichever comes first.
• Documentation of the medical necessity must be submitted to the Insurance Company  if the health plan certifies the students for coverage. (kp.org/HR2851) (SB 1168)

Dependent Children can now be covered to Age 26 detailed information on SteveShorr.com
Family – Income Tax MAGI
Cal Pers drops 9k dependents as they don’t meet the definition californiahealthline.org

Health Care Reform….  Excerpt from Wikipedia Due to the new regulations of guaranteed issue, and allowing children to be included on their parents’ plans until age 26, several insurance companies announced that they would stop issuing new child-only policies.^{[131][132][133]} However, because children would now be covered by their parents’ plans, the Census Bureau found that the number of uninsured 19- to 25-year-olds had declined by 1.6% or 393,000 people by 2011.^[134] Starting January 1, 2014, state health insurance exchanges will be required to offer a child-only coverage option, and Medicaid eligibility will be made available to 16 million individuals with incomes below 133% of the federal poverty level.^[135]

When your child/stepchild gets married or turns 23 (whichever comes first), the child is no longer considered your dependent.

There is one exception: when your child turns 23 but is incapable of self-support because of a physical or mental disability that has existed from before the age of 23. In this case, the child may remain a dependent until the incapacity ends.

Other pages in EmployER Definition – Health Care Reform » EmployEE Definition  Section

• Registered Domestic Partners – Spousal Health Coverage?

• Dependent Definition – Up to Age 26 – Add newborn baby
  • Registered Domestic Partners – Spousal Health Coverage?