HB 1, which became effective in October 2009, requires insurers, Multiple Employer Welfare Arrangements (MEWAs), health insuring corporations (HICs) and public employee benefit plans to offer parents the opportunity to purchase health care coverage for their children up to age 28. This new opportunity must be provided for all policies or contracts issued or renewed, and plans established or modified, on or after July 1, 2010.
Who is eligible? To receive benefits up to age 28, the unmarried child must be:
- the natural child, stepchild, or adopted child of the employee;
- an Ohio resident OR a full-time student at an accredited public or private institution of higher education;
- not employed by an employer that offers any health benefit plan under which the child is eligible for coverage; and
- not eligible for coverage under Medicaid or Medicare.
The coverage expansion applies to the following types of coverage:
- group policies that include coverage for dependents, including COBRA and state continuation coverage
- individual policies that include coverage for dependents, including conversion, open enrollment basic and standard plans
- coverage issued by insurance companies, MEWAs, HICS or public employee benefit plans.
The coverage expansion does not apply to self-insured ERISA plans. It is also important to note that the older age child does not have to live with the parent, be financially dependent upon the parent, or be a student.
Have questions? All technical questions regarding the coverage expansion to age 28 should be directed to the Ohio Department of Insurance (ODI), Product Regulation Division at (614) 644-2644. Also, visit the ODI Web site at www.insurance.ohio.gov for a copy of the Coverage Expansion FAQ issued March 18, 2010.