Parents: Health Care Insurance Reform WILL NOT apply to the Class of 2010. Help!

[calmom]

<p>Geez, unless Sen. Schumer’s daughter has some sort of pre-existing condition, they ought to shop around some. I’m sure they can do better on the private market than $1200 a month. </p>

<p>Thumper – you comment about the confusion is WHY I think that the insurers (and employers) are going to be working on their own protocols for plan implementation right away. They can’t simply play wait-and-see. But its going to take a few weeks to get it all sorted out – they have to run the numbers, have high level executive meetings, and run things by their legal counsel. </p>

<p>But if your employer needs to know by June 15th for Sept. 1 coverage, then its a pretty safe bet that they will have a clear answer from the insurance company by May 15.</p>

[baran1913]

<p>If the child is put back on parent’s insurance plan and he/she is under 26 – how much would the insurance company charge? Is it based on individual rate? – which can be pretty expensive OR based on the “family” rate – which may not increase the insurance rate at all.</p>

[AtomicGirl]

<p>

In the meantime, there is going to be a short-term, government run high-risk pool that people who can’t get insurance because of pre-existing conditions can sign on for right away. The rates for that might be pretty high… but that also sounds a lot like the “public option” that was discarded from the bill – so it might be that there is short-term “public-option” for the hard-to-insure.

In CA the high risk pool is very expensive. About 3 years ago, the premium for my son and myself was just over $1000/month (this was PPO coverage, HMO was about $800/month at Kaiser). I had cancer that was completely cured, and my son had been thought to have a problem which was ruled out. We ended up on the high risk coverage because it was lower than the coverage quoted by the “independent” insurers.</p>

<p>I hope no one ends up with that. Having any insurance at least allows you to pay the “discounted” rates for care that insurance programs contract for. Even if you pay that amount, it is smaller than what you’d pay for no insurance and you are covered for anything big that happens. We are currently on a high deductible plan so we end up paying all our doctor’s visits at the insurance discounted rates. I have friends that are paying higher co-pays than I pay for entire visits. It’s a game and you have to play the game by the rules to maximize your benefits/payouts. Those rules can change depending if you have pre-existing conditions, how old you are, where you live, etc. Good Luck!</p>

[klh720]

<p>for federal employees, I contacted OPM about this. I have BCBS and my son’s coverage runs out in May, when he turns 22. OPM didn’t really have an answer. They said they thought he would be uninsured until next January, when the new plan year starts. Then he could be added again. Not great - 8 months of some kind of temporary insurance.</p>

[twinmom]

<p>To the best of my understanding, New York State had already passed legislation (several months ago) which allows a parent to keep a non-student child on his/her plan until age 29. I called my health insurance company and benefits office at work which both verified this. However, this cost is not cheap. If it is an employee plan, you are responsible for paying the piece for the child that your employer previously paid.</p>

<p>I assume this is what Sen. Schumer is referring to with his daughter.</p>

<p>Calmom: Most new grads here do use HealthyNY if possible.</p>

[twinmom]

<p>The New York State Health Insurance Program (NYSHIP) and The Young Adult Option
Information about young adult coverage for the children of State and Participating Employer NYSHIP enrollees</p>

<p>On July 29, 2009, Governor David A. Paterson signed into law Chapter 240 of the Laws of 2009, which extends the availability of health insurance coverage to young adults through the age of 29. This expansion will assist young adults who do not have access to employer-sponsored health insurance. This law is sometimes referred to as the “Age 29” law, because it permits young adults to continue or obtain coverage through a parent’s policy until the young adult’s 30th birthday. For general information about this law go to the NYS Insurance Department website at [“Age</a> 29” Dependent Coverage Extension](<a href=“http://www.ins.state.ny.us/health/S6030_Age29.htm]"Age”>http://www.ins.state.ny.us/health/S6030_Age29.htm) </p>

<p>The following FAQs address how the New York State Health Insurance Program (NYSHIP) will comply with this law and applies to young adult children of New York State enrollees and enrollees of Participating Employers, i.e. quasi-State agencies, such as authorities, that elect to participate in NYSHIP. </p>

<p>Q. When will young adult coverage be available under NYSHIP?
A. The Young Adult Option coverage under NYSHIP will be available effective January 1, 2010. </p>

<p>Q. I am enrolled in NYSHIP with family coverage. Am I able to add my young adult child to my family coverage at no additional cost to me?
A. No. NYSHIP has elected to provide the Young Adult Option under the new law, and will not be extending the age of dependency for coverage as a dependent under family coverage nor contributing to the cost of coverage for a young adult. Instead, a young adult who meets the eligibility criteria will be able to enroll for individual NYSHIP coverage by paying the full individual premium for the coverage they elect. </p>

<p>Q. Who is eligible for young adult coverage under NYSHIP?
A. The Young Adult Option is available to young adults who meet all of the following eligibility requirements:

1. Be a child, adopted child, or stepchild of a NYSHIP enrollee (including those enrolled under COBRA)
2. Be age 29 or younger
3. Be unmarried
4. Not be insured by or eligible for coverage through the young adult’s own employer sponsored health plan, whether insured or self-funded, provided that the health plan includes both hospital and medical benefits
5. Not be covered under Medicare </p>

<p>Q. Does my child have to be financially dependent on me or reside with me to be eligible for the young adult option?
A. No. The young adult does not need to live with the parent, be financially dependent upon the parent, or be a student. </p>

<p>Q. My 26 year old daughter is currently enrolled for COBRA coverage under NYSHIP. Is she eligible for the young adult option?
A. Yes. However, while the premium for the Young Adult Option will be lower than COBRA premium (COBRA includes a 2% administrative charge), your daughter should consider that if you (the parent enrollee) lose coverage under NYSHIP, her eligibility for the Young Adult Option will end and she will not be eligible for COBRA coverage when coverage under the Young Adult Option ends. </p>

<p>Q. Can my child enroll for dental and vision coverage under the Young Adult Option?
A. No. The new law applies only to health insurance coverage.</p>

<p>Q. Which NYSHIP options are available to my young adult child?
A. A young adult is entitled to the same health insurance coverage as his/her parent provided the young adult lives, works or resides in New York State or the insurer’s service area. Additionally, NYSHIP will permit a young adult to enroll in any other NYSHIP option that is available to the parent and for which the Young Adult otherwise qualifies for enrollment under NYSHIP rules. This means that a young adult may:

1. Enroll in The Empire Plan regardless of the parent’s option;
2. Enroll in the same HMO as the parent if the Young Adult lives, works or resides in the HMO’s service area or in New York State; or
3. Enroll in a NYSHIP HMO that the parent is not enrolled in if the Young Adult lives or works within the HMO service area. </p>

<p>Q. When can I enroll in the Young Adult Option?
A. A young adult may enroll at the following times:

1. During a special 12-month open enrollment period from January 1, 2010 through December 31, 2010.<br>
2. Within 60 days of when the young adult would otherwise lose coverage due to age or loss of dependent student status under the parent’s policy.
3. Within 60 days of when the young adult becomes eligible due to: a loss of his/her employer coverage; relocation of residence or employment into New York State or the service area (please note that NYSHIP’s HMOs have specific, geographically limited service areas while The Empire Plan does not); or otherwise becomes newly eligible due to a change in circumstances (such as divorce).
4. During the annual 30-day open enrollment period. </p>

<p>Q. How do I enroll for the Young Adult Option?
A. Either the parent enrollee or the Young Adult may complete the application form. Proof of the parent/child relationship also must be provided, e.g. birth certificate, as indicated on the application. The first month’s premium also must be remitted. Send the completed application, documents and payment to Jo Cavaliere in the Business Office (x9881). Payment is due each month by the first of the month for which premium is being paid. If payment is not received within the 30-day grace period, coverage will be cancelled.</p>

<p>Q. When will my Young Adult Option coverage be in effect?
A. Coverage will be effective no later than 30 days after NYSHIP receives written notice of the election and payment of the first premium. In most cases, coverage will be effective on the first of the month following receipt of the written notice and payment of the first month’s premium. However, if coverage is elected within 60 days of the date that the young adult otherwise would lose eligibility for coverage as his/her parent’s dependent due to age or loss of student status, coverage is retroactive to the date that the young adult lost coverage. </p>

<p>Q. If I voluntarily cancel my coverage or am cancelled for non-payment can I re-enroll for the Young Adult Option?
A. You may not re-enroll until the next open enrollment period unless you become eligible again because of a qualifying event, e.g. you obtain other employer-sponsored coverage and subsequently lose that coverage. </p>

<p>Q. When will my Young Adult Option coverage end?
A. Your coverage will end if:

1. You voluntarily terminate coverage;
2. Your parent is no longer enrolled in NYSHIP;
   You no longer meet all of the eligibility requirements; or</p>

[twinmom]

<p>Sorry - here’s the last piece of the above:</p>

<p>Q. When will my Young Adult Option coverage end?
A. Your coverage will end if:

1. You voluntarily terminate coverage;
2. Your parent is no longer enrolled in NYSHIP;
3. You no longer meet all of the eligibility requirements; or
4. Your NYSHIP premium is not paid in full within the 30-day grace period, following the premium payment due date.</p>

[patsmom]

<p>

for federal employees, I contacted OPM about this. I have BCBS and my son’s coverage runs out in May, when he turns 22. OPM didn’t really have an answer. They said they thought he would be uninsured until next January, when the new plan year starts. Then he could be added again. Not great - 8 months of some kind of temporary insurance.

</p>

<p>Here’s a link to support that, by the way.
[Child</a> Coverage (4/1/10) – GovExec.com](<a href=“http://www.govexec.com/story_page.cfm?filepath=/dailyfed/0410/040110pb.htm]Child”>http://www.govexec.com/story_page.cfm?filepath=/dailyfed/0410/040110pb.htm)</p>

<p>This isn’t good news for kids who turn 22 before the changes kick in. TCC is the federal version of COBRA, very expen$ive!</p>

[bluebayou]

<p>While corporate plans are changing daily, Anthem Blue Cross of California does not plan to implement until Oct 1…</p>

[calmom]

<p>You might want to also double check as to coverage under the kid’s existing college plan. I emailed the guy at my daughter’s college who coordinates health care benefits and he told me that the basic college plan provides coverage through August 21st. It’s a pretty minimal plan – but it certainly is better than nothing.</p>

<p>At her college - all enrolled students are covered by the basic plan – I assume the premium is covered in the “student fees” we pay on top of tuition each semester.</p>

[gladmom]

<p>I don’t think an employer is required to implement this until its next plan year starts. For us that would be Jan. 1, 2011. Some employers may choose to implement sooner.</p>

<p>[Can</a> My Child Remain on Cobra Longer Than Three Years? - Prescriptions Blog - NYTimes.com](<a href=“http://prescriptions.blogs.nytimes.com/2010/04/08/can-my-child-remain-on-cobra-longer-than-three-years]Can”>Can My Child Remain on Cobra Longer Than Three Years? - The New York Times)</p>

<p>excerpt from ^:</p>

<p>

Under the new health law, children can stay on their parents’ health insurance plans until they reach age 26. The law acts as a floor rather than a ceiling, said Sara Collins, vice president of the Commonwealth Fund, and state laws with higher limits would remain in effect.</p>

<p>The new provision applies to both fully insured and self-insured plans, and takes effect six months after the law’s enactment, or Oct. 1.</p>

<p>There’s some question about when exactly health plans will put this provision into place. They may wait until the new plan year, which could be 2011. On the other hand, some employers are considering implementing the change right away, even before the October start date, according to Kathleen Stoll, director of health policy for Families USA. “I don’t know where all that’s going to land,” she said.

</p>

[musicmom]

<p>gladmom-
Thanks for the link!</p>

<p>This is the first ‘hard’ info I’ve seen that addresses coverage till age 26 in regards to self insured plans.</p>

<p>I’ll be waiting to see my employer’s (self funded) open enrollment info this fall.</p>

[father05]

<p>I did not read pages 3 and 4 of this thread fully, but those of you who have kids graduating this year but have jobs lined up should probably think about holding off if the gap is small. Every time I have received a COBRA notice, you have 90 days from the date of the letter or the date of termination, I think, to decide if you want to continue coverage via COBRA, and I am 99.995% sure this insurance is retroactive to the date of termination (no lapse). </p>

<p>If kid graduates in May, job and insurance start in July, just wait and see if something expensive happens. If not, don’t sign up and pay the couple months worth of premiums.</p>

[atomom]

<p>Good point father05. H changed jobs 2 years ago and we had a situation like that. We didn’t pay, and didn’t need any care during that time, so we saved a couple thousand on our family plan.</p>

<p>My niece graduated last year and was off her parents insurance. They found a high deductible insurance for new grads that was only about $50/mo. Going to look into it for my son who graduates next month. Cheaper than COBRA on parent’s plan. Chances are, a young healthy person won’t need care. But if it is something huge, that’s what you need the insurance for. (Back in 90s, H and I went 6 1/2 years without insurance during grad school. Nothing happened. Do you feel lucky?)</p>

[gladmom]

<p>Another New York Times “Prescriptions” blog post about coverage for adult children who are out of school. The last paragraph has info about some big insurers who are going to implement early. It also reiterates that the extended coverage is not required to take effect until plan years that start after Sept. 23.</p>

<p>[Must</a> Self-Insured Companies Cover Adult Children?](<a href=“http://prescriptions.blogs.nytimes.com/2010/04/26/must-self-insured-companies-cover-adult-children/]Must”>Must Self-Insured Companies Cover Adult Children? - The New York Times)</p>

<p>This is the whole post.</p>

<p>

Question:
Under the new health care plan, will my 22-year-old child (out of school, job with no benefits) be covered by my firm’s plan — even though [the company is] self-insured?</p>

<p>Last year, I learned that the state in which I live — New York — extended benefits for adult children until age 25. I called my plan to discuss this, and they replied that they do not have to comply with the New York State regulation since we self-insure. What is the case with this new federal plan? Is it like the state plan, where we are exempt due to being self-insured? — ADR, New Rochelle, N.Y.</p>

<p>Answer:
Under the new health law, all group and individual health plans must allow adult children to stay on their parents’ policies until they turn 26. This is true both for companies that purchase insurance policies to cover their workers and for those like yours that self-insure and pay claims directly.</p>

<p>About half of states already have laws on the books that increase the age limits for adult children to remain covered under their parents’ plans. Most permit it until kids are in their mid-20s; New Jersey and New York have the most generous limits, allowing adult children to stay on their parents’ plans until age 30. But as you noted, those laws don’t apply to self-insured companies.</p>

<p>The new federal law creates minimum coverage requirements, but states can continue to require more generous treatment under their own laws. But self-insured plans must only meet the new federal standards; the new health law doesn’t subject them to more expansive state laws, say experts.</p>

<p>The extended coverage takes effect for plan years that start after Sept. 23. However, some big insurers — UnitedHealthcare, WellPoint, Humana, Aetna, and Blue Cross Blue Shield — have announced plans to implement the provision early so that graduating students don’t lose coverage. Self-funded plans are not required to adopt this accelerated implementation schedule; they’re responsible for meeting only the Sept. 23 effective date.

</p>

[musicmom]

<p>Gladmom-</p>

<p>Thank you for this link! It is the most specific info I have seen about self insured plans covering young adult children on their parent’s policy.</p>

[ilovedcollege]

<p>I am in California…land of everything expensive. We buy our own health insurance–our D is an only child so we have always bought hers independent of ours since “family plans” make 1 kid cost the same as 10 kids----buying hers separately is just cheaper.</p>

<p>Bottom line- we pay $70 per month for high deductable health insurance. Not a bad deal. Hopefully your son will get a job or you can afford a high deductable plan.</p>

[thumper1]

<p>Well…here’s a twist…if your child will be without coverage before you “open enrollment period”…the open enrollment period does not apply. Employers (in CT anyway) are required to add those who would otherwise be without coverage immediately. OR so my business manager says.</p>

[musicmom]

<p>Mmmmm…
so my will be 24 yr old in Sept son WILL have coverage but only because we bough him an individual policy when he was ejected off my self funded employer plan last Dec.
So, I wonder if my employer will have to let me re-enroll him in Sept, in Jan for new plan year, or not at all?
I work for employer in NJ.</p>

<p>Any votes?</p>

[musicmom]

<p>Ilovedcollege-
We live in NJ…the land of everything expensive also…just on other coast!</p>

<p>We also opted for a high deductible plan for grad school son…about $100/month.
No help for routine visits, just good coverage if he needs hospitalization.
It does provide discounted labwork through their in network lab.</p>