Anthem Changes to the Dependent Age in Ohio

11-10-2015

The state of Ohio recently passed House Bill 201 which lowers the age dependents can stay on a parent’s health care plan. This change applies to plans that meet Affordable Care Act (ACA health care reform law) rules. This law will take effect at your next renewal on or after January 1, 2016.

Individual ACA:

  • Current dependent maximum age is 28 for Individual. The new age limit is 26. This means those dependents1 age 26 or older cannot stay covered on a parent’s policy.
  • Dependents age 26 or older currently on an ACA plan will be automatically removed upon the members’ renewal January 1, 2016, with a termination date of December 31, 2015 at 11:59 PM.
  • Members are being notified via the individual renewal that coverage will terminate on December 31, 2015 at 11:59 PM for any overage dependent (i.e., dependents over the age of 26).
  • Overage dependent letters to impacted members will be sent direct to members approximately 60 days prior to the scheduled termination day.
  • Special Enrollment Period (SEP) qualifying event guidelines do apply.
Small Group (1-50) ACA plans:
  • Current dependent age is 26 with the ability to remain on the plan until age 28 if certain criteria is met per House Bill 1. The extension option to age 28 will no longer apply December 31, 2015 at 11:59 PM. This means those dependents1 age 26 or older currently on the plan cannot stay covered on a parent’s employer’s policy.
  • Current members impacted by this change will be notified by mail 60 days prior and dependents will automatically be cancelled prior to renewal (example July 1, 2016 renewal, dependent will be removed from the plan as of June 30, 2016 at 11:59 PM).
  • When the impacted dependent is terminated from the system a letter will be sent explaining any continuation options available to the dependent.
  • Cobra and SEP qualifying event guidelines do apply.
Legacy plans:

No changes except for Key Fully Insured and Large Group. Dependent ages for these plans are as follows:
  • Individual Legacy – age 28
  • Small Group (1-50)* – age 26 or age 28 with completed dependent affidavit
  • Key Fully Insured (51-99) – age 26 **
  • Large Group Fully Insured or ASO (100+) – age 26** – For other available options, please contact your broker or Anthem representative
If you have any questions about the law or what’s changing, contact BUA.




1Does not apply to dependents covered under a Qualified Medical Child Support Order (QMCSO).
*Age 28 still applies to members using the affidavit process.
**Enrolled dependents currently over age 26 can remain on the plan until the time in which they reach the maximum age allowed per employer contract

AgentSuite

Contact

Jim LaFleur
Phone: 330.576.1131
Toll Free: 1.800.792.6795
jiml@buaweb.com