Insurance companies already implementing provisions of new health reform law ahead of schedule

May 11, 2010

 Washington, D.C. – The health insurance reform law passed by Nevada Senator Harry Reid is already helping to protect Nevada patients from being dropped by their insurance companies, while expanding access to coverage for adult children under the age of 26.  These are just two of the provisions of the Patient Protection and Affordable Care Act (PPACA) that are already being implemented by some insurance companies that operate in Nevada, well ahead of the law’s deadline.

“This law is all about protecting consumers and helping to reduce the number of uninsured in Nevada. While the insurance industry had long fought reform, I applaud those companies that are already implementing some of the provisions in the new law, when it would have been easy for them to put it off until the last minute,” Reid said. “The new law requires insurance plans that offer dependent coverage to extend that coverage until adult children are 26 years old by September 23, 2010, but more than 65 insurers, including dominant insurers in Nevada, have agreed to voluntarily continue coverage before the September deadline. The choice by so many insurers to implement this change in advance of the new law’s deadline shows that health insurance reform was the right thing to do for Nevada’s young people and their families.”


Key policies for young adults under today’s regulations from the Department of Health and Human Services Fact Sheet:

·       Coverage Extended to More Children. The goal of this new policy is to cover as many young adults under the age of 26 as possible with the least burden. Plans and issuers that offer dependent coverage must offer coverage to enrollees’ adult children until age 26, even if the young adult no longer lives with his or her parents, is not a dependent on a parent’s tax return, or is no longer a student. There is a transition for certain existing group plans that generally do not have to provide dependent coverage until 2014 if the adult child has another offer of employer-based coverage aside from coverage through the parent. The new policy providing access for young adults applies to both married and unmarried children, although their own spouses and children do not qualify.

·       Effective for Plan or Policy Years Beginning On or After September 23, 2010. Secretary Kathleen Sebelius called on leading insurance companies to begin covering young adults voluntarily before the implementation date required by the Affordable Care Act (which is plan or policy years beginning on or after September 23rd). Early implementation would avoid gaps in coverage for new college graduates and other young adults and save on insurance company administrative costs of dis-enrolling and re-enrolling them between May 2010 and September 23, 2010. Over 65 companies have responded to this call saying they will voluntarily continue coverage for young adults who graduate or age off their parents’ insurance before the implementation deadline.

·       All Eligible Young Adults Will Have A Special Enrollment Opportunity. For plan or policy years beginning on or after September 23, 2010, plans and issuers must give children who qualify an opportunity to enroll that continues for at least 30 days regardless of whether the plan or coverage offers an open enrollment period. This enrollment opportunity and a written notice must be provided not later than the first day of the first plan or policy year beginning on or after September 23, 2010. The new policy does not otherwise change the enrollment period or start of the plan or policy year.


·       Same Benefits/Same Price. Any qualified young adult must be offered all of the benefit packages available to similarly situated individuals who did not lose coverage because of cessation of dependent status. The qualified individual cannot be required to pay more for coverage than those similarly situated individuals. The new policy applies only to health insurance plans that offer dependent coverage in the first place: while most insurers and employer-sponsored plans offer dependent coverage, there is no requirement to do so.


Access to Insurance: What Young Adults and Parents Need to Do:

·       Check for Immediate Options: Private health insurance companies that cover the majority of Americans have volunteered to provide coverage earlier than the implementation deadline for young adults losing coverage as a result of graduating from college or aging out of dependent coverage on a family policy. This stop-gap coverage, in many cases, is available now. Ask your employer and insurer about this option.

·       Watch for Open Enrollment: If early coverage is not an option with your employer or insurance company, then young adults will qualify for an open enrollment period to join their parents’ family plan or policy beginning on or after September 23, 2010. Insurers and employers are required to provide notice for this special open enrollment period. Watch for it or ask about it.

·       Expect an Offer of Continued Enrollment: Insurers and employers that sponsor health plans will inform young adults of continued eligibility for coverage until the age of 26. To get the coverage, young adults and their parents need not do anything but sign up and pay for this option.