Dependent health insurance coverage can be until age 31 in New Jersey

BY IRENE C. CARD and BETSY CHANDLER

NEWJERSEYNEWSROOM.COM

YOUR HEALTH INSURANCE

If you have group health insurance from your employer, chances are that your children will come off the Plan at age 19 or 23, if a full-time student. Some carriers offer a rider that allows dependent children to continue to age 26. If your adult child ages-off the plan, he/she can still continue benefits under the NJ Continuation Law for 36 months. However, there is an additional option to continue coverage to age 31.

New Jersey enacted a Law that became effective on May 12, 2006. Every year since 2006, they have improved upon this Law. It allows for your adult child (age 19 to 31) to stay on your group health insurance plan if he/she meets the following criteria. The child does not have to live with the parents but he/she must be a resident of New Jersey, cannot be married, and cannot have any dependents. Lastly, they cannot be eligible for any other group coverage. For example, if they get a job with health insurance benefits, they must go on that plan. They cannot continue under the "Overage Child Law". Please note that "overage child law" is not the actual name of the law. The actual name is P.L. (Public Law) 2005, Chapter 375 "Continuation Coverage for Eligible Dependents Until 31 Years of Age". It is referred to as the Overage Child Law. This Law applies only to health insurance. It does not include dental coverage. When this Law was first effective in 2006, it went to age 30; now it has been extended to age 31.

This law pertains to all size insured groups with a New Jersey group health insurance plan. Please note it must be a NJ group health insurance plan. If you work in NJ for a company headquartered in California, and you have a California group health insurance plan, then this new law does not apply.

If your adult child applies for this coverage, and then moves out of NJ, he/she loses the coverage. If he/she moves back to NJ at another time, still under 31 years of age, and still meeting the other requirements described above he/she can apply for the coverage again.

The parents or adult child are responsible for paying the premium. The premium is less expensive for the adult child to continue on the group health insurance plan under Dependent to 31 or Overage Child Law (call it what you wish) that to continue benefits under NJ Continuation Law or the COBRA law which allows the adult child to stay on the plan for 36 months. The formula for calculating the premium varies from one insurance carrier to another. With Horizon Blue Cross Blue Shield New Jersey, the premium is 60.8 percent of the single premium. It is a win-win situation.

When an overage child seeks continuation of coverage under Chapter 375 (this new Law), the parents must be covered under the group plan at that time. If an overage child is eligible for Medicare, he/she cannot get coverage under Chapter 375.

Suffice it to say, if the premium is not paid, coverage can and will be terminated.

Irene Card & Betsy Chandler are licensed insurance professionals working at MIC Insurance Services, a health insurance services company. If you have questions relative to this column or other related topics, we invite you to call (973) 492-2828, or visit our web site at www.micinsurance.com.