What If My Child Becomes Too Old for My Employer's Health Plan?

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As your children get older, they become ineligible for your employer’s health plan. One way that the Affordable Care Act (ACA) has changed this is to increase the age at which children become ineligible for group health plans to 26. Still, the question needs to be asked: what do I do when my child becomes too old for my employer’s health plan?

The good news is that you and your child have options. The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) gives individuals the right to continue their group health insurance if coverage is lost due to a specific qualifying event.

Qualifying Events

There are five basic qualifying events, any one of which can trigger COBRA continuation coverage.

• Termination of employment or reduction in work hours
• Death of an employee
• Divorce or legal separation
• Covered employee becoming eligible for Medicare
• Dependent child ceasing to be classified as dependent under the terms of the plan

When your child is no longer eligible as a dependent under the terms of your health plan, he or she has the right to continue to receive those benefits under COBRA.

Notification

You are required to notify the plan within 60 days when your child is no longer a dependent under the terms of the plan. The plan then has 14 days to provide an election notice to your child. The election notice will detail everything your child needs to know about his or her COBRA rights, their coverage options, and the costs associated with taking continuation coverage. While COBRA gives your child the right to continue healthcare coverage under your employer’s plan, they will be responsible for paying for that plan. The cost can be up to 102% of the price of the plan (your contribution plus your employer’s contribution, plus 2% administrative costs).

Each of your children (if you have more than one) is eligible independently for COBRA continuation coverage. If you have two children who both lose eligibility under your healthcare plan at the same time, each of them will receive independent election notices, and each of them will have the choice whether or not to elect COBRA coverage.

Maximum Period

If your child elects continuation coverage under COBRA, they may keep the coverage for a maximum of 36 months from the date they officially lost coverage. See your election notice for complete details about your specific plan options.

Need Help?  Contact RedQuote!

RedQuote helps beneficiaries understand their COBRA plan benefits and can provide them with information about individual plan options to help them choose the best plan for their age, budget and coverage preferences. If your company might be interested in hiring us to manage COBRA benefits for beneficiaries coming off your group medical plan, contact us today!

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Published Apr 26, 2017.