Health Plan “Early Adopters” for Extended Dependent Care Coverage

by Clive Riddle, April 22, 2010

The bandwagon started rolling at full steam this week for major health plans to allow applicable dependent coverage up to age 26 in advance of the September 23^rd, 2010 effective date provided in The Patient Protection and Affordable Care Act.

HHS has been in communication with a number of major plans for purposes of stimulating such an initiative. On Monday, April 19^th during the day, UnitedHealthcare and WellPoint issued releases regarding their new policy in this regard. HHS Secretary Kathleen Sebelius issued a statement discussing the initiative, and acknowledging the two health plans.

Monday evening Humana issued their release in this regard, and the Blue Cross Blue Shield Association issued a release on Tuesday committing the entire association of Blues plans. It’s interesting to note the WellPoint’s statement came ahead, and wasn’t coordinated with announcement of the BCBS Association policy. HHS Secretary Kathleen Sebelius issued a follow-up statement on Tuesday acknowledging Humana, the BCBS association and Kaiser Permanente. Kaiser has not issued a formal public statement in this regard, but made a general commitment to HHS and has acknowledged their position with the media.

On Wednesday the 21^st, Aetna issued a statement announcing their plan to extend coverage, without providing specific details. CIGNA has not yet issued a statement. Local and regional plans (other than BCBS plans) generally have not yet issued such statements, due to the fact the initial HHS outreach was to national plans, and more to the point in a number of regions because state laws already require dependent coverage until age 26 or higher.

Regarding the varying state dependent coverage requirements, one example, as the Dayton Daily News reminds readers is that "in Ohio, that age will rise to 28 on July 1, under the provisions in the two-year budget state lawmakers approved last year." The National Conference of State Legislatures (NCSL), in a web page dedicated to the state-by-state coverage issue on this topic, provides a summary of various state initiatives to address this issue, that started all the way back in 1994, when "Utah become the first state to enact legislation allowing coverage for unmarried dependents to continue up to age 26, regardless of school enrollment status." New Jersey enacted legislation extending dependent coverage to age 31 in 2006 and the NCSL notes that now "at least 30 states have now enacted similar legislation to extend dependent coverage regardless of enrollment in school." (NCSL provides a state by state table in their web site.) The Robert Wood Johnson Foundation also provides a web site dedicated to State Coverage Initiatives that summarized Dependent Coverage provisions.

Regarding the details of the national plans extension of dependent coverage (with links to their statements):

• UnitedHealthcare’s change is effective immediately. They state “this extension of coverage applies to college students who currently are covered under their parents' fully-insured health plan offered through UnitedHealthcare. Individual family health plans through UnitedHealthcare's Golden Rule business already allow all dependents to stay on the plan until age 26 and enrollees do not need to take any action.”

• Humana’s change is also effective immediately, and they note “the decision by Humana directly impacts the adult children of members who are enrolled in Humana’s fully insured lines of business. (Children of members enrolled in a HumanaOne individual health plan have already been able to remain on their parents’ or guardians’ coverage until age 26.) Humana is also encouraging large employers who self-fund their coverage with Humana to extend coverage to the adult children of their employees who would otherwise lose their coverage this year.”

• WellPoint’s policy will take effect June 1^st. They state that at that time “WellPoint's affiliated health plans will automatically retain these young individuals on their parents' policies in both fully insured group and individual health plans. Our self insured clients and members will have the option of not offering this extended coverage.”

• The BCBS Association policy is also tied to June 1^st, but further equivocates that the extension is only definite for individual plans, and that they will make the option available to their employer groups, as they state “every Blue Cross and Blue Shield company has agreed to allow covered individuals under age 26 to remain on their parents' individual health insurance policies effective June 1. We will offer this extension of coverage to our employer accounts for their members.”

• Aetna for now is at the stage where they are “working with their customers” to develop a policy: “We understand that young adults are concerned about potential gaps in health care coverage. We are working with our customers to allow young adults to remain on their parents' plan until the dependent coverage requirements of the Patient Protection and Affordable Care Act go into effect later this year. We believe this is in the best interests of our members and is in keeping with the spirit of the health reform law.”

• Kaiser was cited in USA Today as planning “to extend coverage before September to consumers who have individual policies and is in discussions with employer groups about their policies. Details are still being worked out, ‘but our intent is to avoid an interruption in coverage for them,’ spokesman Chris Stenrud said.”

Comments

[Linda Flink]

Great health care blog! Thanks for being so generous with all these meaningful information and quick updates on health care. More power to MCOL!

Linda Flink
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