I guess as an employer who pays for family coverage—is it fair to my company to pay for a 24 year old when they have coverage available at their own employer? Our family plan costs the company additional $$$ for each child in the plan. It is not free to the employer who pays the bulk of the premium.
^^^ Very true. Our employers do not allow anyone but the employee and minor children to be covered, and even a spouse pays a monthly surcharge if they have employer based insurance of their own. Dependants with their own employer insurance are not eligible for coverage at all. I certainly don’t hold that against employers; they aren’t made out of money, either.
It’s galling when the employer is the federal, state or local government (and pays a very large percentage of the spouse/family premium). Why should the taxpayers subsidize an employee’s family members who could get coverage via their own employer?
H’s policy has only two options–self and family. For family, the premium is the same whether it is employee and spouse or employee, spouse and all children under 26. H was informed that all his kids under 26 were covered, even if they lived in a different household and even if they worked full-time and had insurance offered by their employer. This was our insurer’s interpretation of the ACA, effective 1/1/2011. Because of this, S didn’t have his employer cover him until the month he turned 26 and lost coverage under H’s policy. He saw no good reason to have dual coverage and H’s insurer agreed that there was no good reason for S to have two policies.
Bay, our kids are lucky that we are here for them to help them navigate all these new rules and laws.
My kid would never have understood how having and contributing to an IRA could allow her to max out the subsidies for her health care. She was overwhelmed by the cost of the insurance premiums and just laughed when I said she needed to add more to her IRA.
I do believe that any company that covers minor children had to then cover children up to age 26. @greenbutton I wonder if your company is not following the law or if I just am missing something. Here is the link. US Dept of Labor
@HImom. I just found out that the FEHB is going to institute a Self + One enrollment type starting in 2016. This is great news for us, as our youngest son just turned 26 this year. So next year we’ll be able to save a few bucks by not buying the Self + Family plan anymore.
http://www.opm.gov/healthcare-insurance/special-initiatives/self-plus-one/
I had an “ex” employee that still wanted his 24 year old son on my plan because his son’s single individual health plan was going to cost his son 200 bucks a month at his new 75,000 job.
Sounds like a smart employee. If buying the son’s health insurance through you is cheaper than buying through the son’s employer, why wouldn’t he want to do that? Either offer that option and don’t complain when people take you up on it, or don’t offer it.
Employers cannot exclude a child who is under 26, even if he has his own job, other health insurance options through a school, a spouse with insurance, etc. ACA allows any child who is under 26 to be on the parent’s group policy. If not, the policy is not ACA compliant.
Most group policies are superior to individual policies. Many of the policies under the exchanges have high deductibles (excluding the exams and tests required by ACA like well baby, vaccinations, mammograms). My brother was happy with his individual policy. I think he paid about $300 per month. They no longer offer that policy, a similar policy would cost him about $1000/mo and has a $5000 deductible, so $17000 per year before any real benefit.
Dental ‘insurance’ is not health insurance. It is a group contributing to a pot of money, and if that pot actually is used up, the ‘insurer’ doesn’t have to pay. Most ‘pots’ have plenty of money and never run out, but it is possible. That’s why there is a maximum per year, usually $2500-4000, and if you need more than that, too bad. Some dentists won’t agree to drop their prices to the max allowed by the insurer, so will give you the forms to send in but won’t become part of the network.
Employers cannot exclude a child who is under 26, even if he has his own job, other health insurance options through a school, a spouse with insurance, etc. ACA allows any child who is under 26 to be on the parent’s group policy. If not, the policy is not ACA compliant.
This is not true in our case. I am covered under hubbie’s plan (I do not work), but if I were to take a job with health insurance available, I am excluded from coverage by his plan. Same for our kiddo with employer sponsored plan
available. And this plan IS ACA compliant…
RE: the 21 year old on our employer sponsored plan rather than his own employer sponsored plan–my husband’s employer has no objection to keeping kids on the plan to age 26, and we are paying most of his premium. Which we are happy to do for the reasons stated above. The company H works for has always been family-friendly so not surpising that they support this.
I agree that leaving a kid with significant medical issues to figure it out for himself is unreasonable, especially since we would be the ones picking up the pieces.
How do you edit? Meant to say H’s employer has no objection to keeping kids on the plan even if the kid is eligible for his own employer’s insurance.
@patsmom, I always wondered when FEHB would offer self + one in addition to self only and family. I will be curious to see how premiums and benefits may differ among these 3 different options. Thanks for the heads up. This nay be our first open season when we don’t have a child < 26, so good timing for us.
One of my kids is low-income and living in a non-expansion state. We have to face this in 2 years. I couldn’t care less if someone thinks I’m helicoptering, I will do everything I can to help her figure this all out. It’s so complicated. How do you figure out how much of the monthly premium is subsidized? The rates I’m looking at for her area are very high (300/mo for silver) but she’s very low income and can’t afford anything like that at all.
When my kids are working…I won’t pay rent, or utilities. But I would scrub floors if needed to pay for health insurance if they were unable to do so.
And yes, I would and did help both when they were getting their first individual policies. It’s not easy. Both made their own decisions in the end, but got lots of help from the parents.
My S has been on his own for rent, utlities and travel since he got out of college in 2010. D still hasn’t gotten a job yet, so we shall see what she can afford when she gets a job. She has tried to keep her expenses very low (e.g. $700/month including utliities for a room in a house), so we haven’t complained but are looking forward to her making her own way. We will make sure that she has an effective health insurance policy at all times, whether through her workplace or paid by us. it’s just too scary and expensive to go without a policy.
@electronblue, if her income is low enough, she will qualify for Medicaid, you can Google each year the Federal Poverty level for ACA.
It appears her state only offers medicaid for pregnant women, children, the blind, and disabled. This is a non-expansion state. Perhaps I’m reading that wrong but it seems in non-expansion states where poor adults are not able to afford the premium they are excused from the tax penalty and are allowed to not have insurance. Not very helpful.
Electron, if she is in a non expansion state then she qualifies for subsidies starting at an income of $11,700 per year. If she is above that then she can buy on the exchange. Unfortunately if she is below that she can still buy on the exchange but there will be no subsidy.
If only there were a high deductible plan available on the exchanges that didn’t cover the routine expenses that you could pay out of pocket as needed, but would protect you against a catastrophic illness or accident. You know, insurance instead of pre-paid health care.