Health Reform

Latest news and updates link https://www.blueshieldca.com/producer/news/health-reform/home.jhtml


Extension of dependent coverage until age 26
Reinsurance for early retiree plans
New rules for enrollees with pre-existing conditions
Changes to lifetime or annual limits on "essential health benefits"
Coverage of preventive health services
Health & Human Services (HHS) consumer website launches
New rescission rules
Details on "grandfathered" health plans

Detail for Extension of dependent coverage until age 26
Extension of dependent coverage until age 26 As part of the new federal health reform law, dependents have the option of staying on their parents’ group or family health plan until age 26, regardless of student, residency, employment or marital status. Prior to the new legislation, health plans commonly imposed an age limit of 23 years old for dependents who were full-time students and 19 years old for dependents who were not full-time students.The law states that this new provision must go into effect on September 23, 2010 for group plans and January 1, 2011 for individual and family plans. However, Blue Shield of California chose to implement this provision early for its members. On June 1, 2010, Blue Shield began allowing dependents who would have previously "aged-off" of their parents’ plan to remain on that plan regardless of student status, up to age 26. Dependents who reached 26 years of age on or before May 31, 2010 or were dis-enrolled because of their student status, may re-enroll when their parents re-enroll at open enrollment for an effective date on or after the September 23, 2010 or their parents renew their individual plan effective January 1, 2011 . For ASO and custom groups, this maximum age may vary by contract, but may only be higher than 26.The only eligibility requirement, other than age, is that the dependent must be a child of the covered parent. For example:Subscriber enrolled through his/her employer: A son turned 23 years old in May 2010 and was dis-enrolled from his parent’s plan. The son may now re-enroll on his parent’s plan at the next plan renewal on or after September 23, 2010 (in this scenario, May 2011).Subscriber enrolled through an Individual and Family Plan (IFP): A son turned 23 years old in May 2010 and was dis-enrolled from his parent’s plan. The son may now re-enroll on his parent’s plan on January 1, 2011. NOTE: for an IFP plan, any dependents that "aged-off" only have a 30-day time period from January 1, 2011 through January 31, 2011 to re-enroll. Once this time period is completed, normal Blue Shield of California Underwriting policies will be enforced.Remind groups of the option to re-enroll dependents up to age 26Group members will be allowed to re-enroll covered dependents up to age 26 for any renewals on or after October 1, 2010. Members must act fast since re-enrollment is not automatic. Please remind your clients when you are talking about renewals. Blue Shield will be providing groups with a sample notices to be given to their employees at open enrollment.