Starting in 2016, Age 26 is the New 28 for Ohio Employers
For employers in Ohio sponsoring a fully-insured health plan, administering dependent coverage will be a little easier in 2016 thanks to recent legislation. Generally, the ACA requires that health plans that cover dependents make that coverage available until a child reaches the age of 26 with no restrictions. Without debating the pros and cons of this requirement, at least it was easy to incorporate into employer health plan documents and administrative practices when it became effective (yes, “easy” and “ACA” just appeared in the same sentence).
However, states may still muddy the waters by imposing stricter coverage requirements. For fully-insured plans, Ohio law requires that employers provide dependent coverage to children until they reach the age of 28. The age extension is not too difficult, but Ohio also hinges a child’s eligibility after age 26 on several conditions that are ultimately the responsibility of the plan administrator to monitor – unmarried, a resident of Ohio or a student, not offered coverage through their own employer, etc.
With surprisingly little fanfare, Ohio recently passed legislation that eliminates this requirement effective January 1, 2016, effectively conforming Ohio law to federal law for fully-insured plans (though Ohio law still requires employers to provide coverage for certain disabled dependent children regardless of age). While advance notice may not be required, you may consider warning your employees of the pending change before open enrollment to give those with covered children over age 26 enough time to plan ahead. Otherwise, sit back, kick your feet up, and enjoy crossing a few more questions off your enrollment forms!