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.
Eligible Dependents
Individual & Family Policy Definitions
Dependent eligibility
To be eligible for coverage as a Dependent, the individual must meet all eligibility requirements listed above, as well as certain Covered California Dependent eligibility requirements. The individual must:
Be listed on the enrollment form completed by the Subscriber; and
Be the Subscriber’s spouse, Domestic Partner, or be under age 26 and the child of the Subscriber, spouse, or Domestic Partner.
o For the Subscriber’s spouse to be eligible for this plan, the Subscriber and spouse must not be legally separated.
o For the Subscriber’s Domestic Partner to be eligible for this plan, the Subscriber and Domestic Partner must have a registered domestic partnership.
o “Child” includes a stepchild, newborn, child placed for adoption, child placed in foster care, and child for whom the Subscriber, spouse, or Domestic Partner is the legal guardian. It does not include a grandchild unless the Subscriber, spouse, or Domestic Partner has adopted or is the legal guardian of the grandchild.
o A child age 26 or older can remain enrolled as a Dependent if the child is disabled, incapable of self-support because of a mental or physical disability, and chiefly dependent on the Subscriber for economic support.
The Dependent child’s disability must have begun before the period he or she would become ineligible for coverage due to age.
Blue Shield will send a notice of termination due to loss of eligibility 90 days before the date coverage will end. The Subscriber must inform Covered California of the Dependent’s eligibility for continuation of coverage within 60 days of receipt of this notice in order to continue coverage.
The Subscriber must submit proof of continued eligibility for the Dependent at Blue Shield’s request. Blue Shield may not request this information again for two years after the initial determination. Blue Shield may request this information no more than once a year after that. The Subscriber’s failure to provide this information could result in termination of a Dependent’s coverage. Blue Shield EOC *
…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
Lifetime Coverage for disabled child over 26
FAQ’s
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?
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Consumer Links
Specimen Health Reform Individual Platinum Policy – Eligible Dependents Page 25
California Insurance Company Forms & Applications
Anthem Blue Cross 9/1/2010 Bulletin
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)
Technical Links
Our Marked Up Copy of Federal Register
CA enacted SB 1088 2010 Price Insurance Code 10277 to require Insurers to conform with PPACA (Obama’s Plan)
Federal Regulations – Student Health Plans
Blue Cross Small Group Administrative Manual
Loss Ratio is higher for kids on parent’s plan vs those who have their own coverage Washington Post
Staying on Health Plan if Disabled beyond age 26
Blue Cross
Employer enforcement of exclusion for dependents who are eligible for their own employer-sponsored coverage
The health care reform law allows grandfathered group health plans to exclude coverage for young adult dependents who are eligible for their own employer-sponsored coverage. While we aren’t making this exclusion standard, 100+ grandfathered groups can choose to have the exclusion. If a group chooses to exclude coverage for dependents who are eligible for their own employer-sponsored coverage, we will add the exclusion to the group’s certificate language. However, we will not enforce the exclusion on behalf of the group. The employer will need to develop a method that suits its particular needs, as well as materials that support the enforcement method (such as an affidavit for employees to verify that their covered dependents are not eligible for their own coverage). (Blue Cross 12/3/2010 Bulletin)
Historical Links
Covered CA problems with implementing the law.
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
If my 18 year old son joined the National Guard and is still in high school, can he remain on my medical insurance?
I don’t see why not.
On the other hand –
Are you getting subsidies from Health Care.Gov??
https://individuals.healthreformquotes.com/subsidies/intro/calculation/family-glitch/
https://www.kff.org/faqs/faqs-health-insurance-marketplace-and-the-aca/when-can-i-apply-for-marketplace-premium-tax-credits-when-other-coverage-is-available/
Does the National Guard provide Minimum Essential Coverage?
https://individuals.healthreformquotes.com/individual-mandate/5000-mandate/mec/
(iv) medical coverage under chapter 55 of title 10, United States Code, including coverage under the TRICARE program; [2](v) a health care program under chapter 17 or 18 of title 38, United States Code, as determined by the Secretary of Veterans Affairs, http://medicare.healthreformquotes.com/medicare/publications/veterans/ in coordination with the Secretary of Health and Human Services and the Secretary,
https://nationalguard.com/benefits/insurance
https://nationalguard.com/tricare-insurance
TRICARE Reserve Select is a premium-based plan available worldwide for qualified Selected Reserve members of the Ready Reserve and their families.
If purchased, TRICARE Reserve Select is minimum essential coverage under the Affordable Care Act.
http://www.tricare.mil/
Premium Costs
https://www.tricare.mil/Costs/HealthPlanCosts/TRS.aspx
I’m not the one to ask about Tricare, but it looks like it would cost $459/month… Thus, it doesn’t appear there would be problems, even if you are getting subsidies in Health Care.Gov
Dual Coverage?
https://individuals.healthreformquotes.com/definitions-glossary/dual-coverage/
Please send a copy of your Plan ID card to [email protected] – we won’t post that, our email is encrypted sending & receiving by Paubox.com
Please also send a copy of your Evidence of Coverage https://individuals.healthreformquotes.com/appeal-grievances/plain-meaning-rule/eoc-platinum/
If you don’t have it, we might be able to access it, once we have the exact name of your plan.
My Father passed away. I’m now the primary caretaker for my 18 year old brother. I will be filing taxes as head of household. Can I add by brother to my group health plan?
Wow, it looks like you can. See Blue Cross Administrator Guide page 26

Basically, if you assume parent child relationship. Clearly an 18 year old is under 26.
Go to our Carriers Page then go to the administrators page to get the enrollment forms.
I’m 30 years old, recently got my Master’s Degree and am looking for a job. What do you suggest for health Insurance?
If you have no earnings you can enroll in Medi Cal. We don’t get compensated to help you with that, so our support is limited. Medi Cal information is on my website along with their contact information.
If you earn between $17k and 70K you can get Covered CA Subsidies.
If you want a private plan, you can get that now, as it’s open enrollment.
Click here for quotes for private and Covered CA coverage.
We are compensated for private & Covered CA so you get our full service. Email [email protected] is the best way to reach us.
When you find a job, if it includes health coverage you can just cancel any of these plans.
College health plans?
https://californiahealthline.org/news/college-wont-be-fun-if-youre-not-healthy-some-advice-about-health-insurance/
What about if my child is disabled and can’t earn a living?
See our page on just that topic
What about Grand Children?
See specimen policy on dependent definition. Do the grandparents have LEGAL guardianship. Court orders or on OFFICIAL paperwork and forms!
UHC won’t do it, unless there is legal guardianship
(c)Coverage of grandchildren not required. Nothing in this section requires a plan or issuer to make coverage available for the child of a child receiving dependent coverage.https://www.law.cornell.edu/cfr/text/45/147.120