Expert's View

Since enactment of the national health insurance reform law in March, there’s been a steady stream of questions regarding when one of the provisions, extending FEHB eligibility for children up to age 26, four years longer than under current policy, will take effect. What better update on this important subject could there be than the latest word from OPM. So as not to leave out any detail that might be important to someone, here’s the whole thing:

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"The U.S. Office of Personnel Management has been preparing to implement the Affordable Care Act since the day it was signed into law. We want Federal employees, retirees, and their families to enjoy the benefits of this landmark legislation as soon as possible, and we are working on this with our partners in the White House, Congress, U.S. Department of Health and Human Services, and other agencies every day.

"Under the Affordable Care Act, adult children up to age 26 will be eligible for health insurance coverage at the start of the next benefit plan year. The effective date of this provision is the first day of the plan year that is six months following enactment of the law. For the Federal Employees Health Benefits (FEHB) Program, that means January 1, 2011. Though we are eager to provide coverage to young adults prior to January 1, the current law governing the FEHB Program specifically prohibits us from doing so. Chapter 89 of title 5, United States Code, says unmarried dependent children are covered until age 22. Until the new law goes into effect, we must follow existing law.

"We are working diligently with the Congress to address this matter and Congress has introduced legislation to address this issue.

"In the meantime, children turning 22 are automatically covered for an additional 31 days under the parent’s coverage policy. During this time, families can decide to continue FEHB coverage for their adult child for up to 36 months through the Temporary Continuation of Coverage (TCC) program. Under TCC, adult children can continue their coverage by enrolling as an individual in any FEHB plan. Though there is no Federal contribution toward the premium, the coverage policy is not subject to underwriting or pre-existing condition exclusions. Information about TCC is available at www.opm.gov/insure/health/faq/tcc.asp."

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It warms the heart to think of how sensitive the Congress has become both to changing times and the needs of the few who will benefit from this provision of law when it becomes effective. However, the more I think about extending coverage for children up to age 26, the more I’m amazed by how elastic the word "children" has become.

It’s no stretch of the imagination to conclude that some of the families who will benefit from this provision have sons and daughters who are either in school working toward higher academic degrees or have graduated and haven’t yet found a job. It also isn’t any stretch to imagine families where those "children" are just hanging around home and amusing themselves with electronics, remaining dependents of their parents. Some of those "children" may well postpone any plans of self-supporting employment or marriage, since either would nullify their eligibility for health insurance under this provision.

Someone far more clever with words than I (and with a cynic’s view of the world) dubbed this latest bit of legislation as the "Millennium Generation Full Unemployment, Video Game Maximization and Shacking Up Encouragement Act." Once again, where you stand on a subject depends on where you sit.

 

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