Ask the Expert: Insurance for kids up to 26 is the law

You've written that group insurance plans must now cover dependent children up to age 26. But when I contacted my insurer, I was told they did not have to follow the new law. My husband works for a major company with thousands of employees, but his insurance is with his union. Is that why it doesn't have to follow this law?

Your husband's plan does have to follow the law. This rule applies to all group health plans -- including collectively bargained union plans -- starting Sept. 23, 2010, or the first plan year thereafter. For many plans, that means starting in January 2011.

All employer-sponsored plans that provide dependent coverage for children must extend the eligibility age for that coverage to 26 - and your child doesn't have to be a student, or your financial dependent, or live with you, to qualify for the coverage.

The rule applies to both new plans and to "grandfathered" group insurance plans - i.e., plans that were in existence on March 10, 2010, when the law was passed, says Shawn Nowicki, director of health policy at the New York Business Group on Health.

The only exception: "Grandfathered" plans don't have to adopt it until 2014 for dependent children who qualify for health insurance in another employer's plan. But many "grandfathered" employer-sponsored plans are voluntarily complying with the law from day one.

If you were correctly informed, there are only two possible reasons: Your child is eligible for coverage through his own employer, or your husband's plan doesn't offer coverage for dependent children at all -- and in a union plan that's very unlikely, Nowicki says.

The bottom line.  All employer-sponsored health plans that provide dependent coverage for children are required to extend the eligibility age for that coverage to 26.

Websites with further information. Click here to link to hhs.gov/ociio/regulations/adult_child_fact_sheet.html.  Click here to link to dol.gov/ebsa/faqs/faq-dependentcoverage.html.