Extension Of Young Adult Coverage 

All health plans must permit adult children to remain on their parents' plans until age 26. It makes no difference if the young adults are married or financially independent. As long as children don't have an offer of coverage from their own employer, parents can keep them on their plan.

If you want to put an adult child on your plan, you'll be given an opportunity to do so during a special enrollment period. At most companies that will coincide with open enrollment, say benefits consultants. Even if it doesn't, insurers and employers are required to notify you of the special enrollment period. Look for that notice. 

Under the law, plans can't charge more for adult children than for dependents younger than 19. But they can increase the cost of family coverage overall, and many will do so, according to an employer survey released last week by the benefits consulting firm Mercer. The survey found that more than half of employers that plan to shift more costs onto employees' shoulders will do so by disproportionately increasing the cost of family coverage compared with employee-only coverage. 

As part of their efforts to rein in costs, employers are also more likely than before to ask employees to verify that dependents are eligible for coverage, say experts. More than 40 percent of ineligible dependents are children younger than 19, says Karen Frost, health and welfare practice leader for human resources consultant Hewitt Associates. 

Often the eligibility change is part of the fallout from divorce. Children may no longer live with or be financially dependent on the parent whose insurance covered them, for example, potentially making them ineligible under plan rules. "Most of the time, employees are covering ineligible dependents because they don't know the rules" of their plan, says Frost. 

This can also be true for adult children on their parents' plans. 

Prohibition On Coverage Exclusions For Children With Preexisting Conditions 

Employer plans can no longer refuse to cover children younger than 19 because they were born with or develop a serious medical condition. The ban on coverage exclusions also applies to new individual policies purchased for a child. 

However, even though the new law allows adult children to remain on their parents' plan until age 26, once they are 19 they could be refused coverage for a preexisting condition, says Tracy Watts, a partner at Mercer. 

A similar ban on coverage exclusions for adults goes into effect in 2014. 

Restriction On Annual Dollar Coverage Limits 

In general, employer plans can't impose annual coverage limits of less than $750,000 for "essential" health benefits, including hospital services, drugs, emergency services and maternity and newborn care. The maximum limits increase every year and they are eliminated in 2014. These limits apply to new individual policies, too. 

Additional provisions take effect on or after Sept. 23 for new plans offered by employers or purchased by individuals since March 23. These include requirements that insurers: 

*Cover the full cost of preventive services that have the highest recommendation of the U.S. Preventive Services Task Force. 

*Allow women to see an OB-GYN without a referral. 

*Do not make plan members pay higher co-payments or coinsurance for out-of-network emergency services. 
 
 
The fight to obtain relief for mini-med plans from the Affordable Care Act’s (ACA) MLR calculation took an encouraging but not yet conclusive turn last week. Although many insurers (including Aetna) have obtained their waivers as to restricted annual limits, no such plan or product could ever meet the 85 percent MLR requirements of ACA.  Aetna has led an ad hoc coalition of employers, insurers and agents in fighting for an exemption from the MLR calculation based on the unique characteristics of mini-med plans.  A Wall Street Journal story revealed that a major employer (McDonald's) was contemplating dropping mini-med coverage for 30,000 of its employees, an example of the new law's unintended consequences. The story further led HHS and the White House both to issue a press statement and host a conference call with some members of the coalition late in the week.  Aetna took the lead in providing the Administration with information (data, policy and legal documents) in support of its position that the issue could be quickly resolved by exempting mini-med plans from the MLR calculation and thereby preserving coverage for 1.4 million citizens. A decision from HHS is pending.
 
 
SACRAMENTO, Calif. (AP) - Gov. Arnold Schwarzenegger has signed seven major health care-reform bills, including legislation establishing an insurance exchange that will allow consumers to comparison-shop for coverage.

The governor's action on Thursday makes California the first state to implement an oversight board for insurance exchange marketplaces since the new federal law was enacted earlier this year.

Additional bills in the package prohibit insurers from denying coverage to children because of a pre-existing condition and allow young adults to stay on their parents' health care plans until age 26.

The legislation aims to bring the nation's most populous state in line with federal reforms scheduled to take effect in 2014.

(Copyright 2010 by The Associated Press. All Rights Reserved.)