Adult Child Coverage to Age 26 and the Affordable Care Act

Source: NYSUT Social Services

The Affordable Care Act requires employer-sponsored plans that offer dependent coverage to cover adult children until age 26. Unlike the New York state "Age 29 - Young Adult Option" COBRA-like coverage, no additional premium other than regular family premiums will be required. This will benefit many young adults who previously were unable to afford insurance.

Eligibility for coverage under their family plans will begin with the next plan renewal date. For Empire Plan participants, that date is January 1, 2011. For health plans that renew next July, for instance, the effective date would be July 1, 2011. For more information concerning your plan's renewal date and the special 20-day open enrollment period, please contact your employer.

Important Considerations:

  1. Young Adults can be covered to age 26 regardless of student status, financial dependence or residence.
  2. Both married and unmarried adult children qualify.
  3. Only plans that offer dependent coverage will be required to offer the extended coverage, but the vast majority of group health plans offer dependent coverage and many family policies exist in the individual market.
  4. If the adult child is working and eligible for health insurance through his or her employer, the parents' employer may or may not be required to cover him/her. Please check with your employer.
  5. It is not required for retiree only or separate dental and vision plans to cover adult children to age 26.
  6. The value of employer-provided health coverage for adult children to age 26 is excluded from an employee's taxable income.

If you have any further questions about eligibility of a young adult call NYSUT Social Services at 1-800-342-9810 x6206.

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