My disabled dependent child is currently enrolled on our plan

How long can he stay on as a dependent child?

If my employer switches plans or I get a new job, will my child be covered under the new plan?



Blue Shield says that they will only cover disabled dependent children that are already enrolled on our group plan that happen to age out.

Our Blue Shield of CA medical EOC says:

Enrolled disabled Dependent children who would normally lose their eligibility under this Health Plan solely because of age, may be eligible for coverage if they continue to meet the definition of Dependent.

***Please when stating facts, provide a screen shot, URL – Internet Address or something.   Here’s an actual EOC – Evidence of Coverage from Blue Shield for the PPO Platinum Plan.   We don’t like hearsay  (Federal Rules of Evidence)

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Here is what we show the actual policy provisions to be:

If the employee or member changes carriers to another insurer or to a health care service plan, the new insurer or plan shall continue to provide coverage for the dependent child. CA Insurance Code 10277 (d)

A Dependent child who reaches age 26 becomes ineligible on the day before his or her 26th birthday, unless the Dependent child is disabled and qualifies for continued coverage as described in the definition of Dependent.  Page 60 of the EOC
Page 15 of the Group Administration Guide says virtually the same thing.
Our wholesalers – General Agent’s website says:
Yes, pending approval from Patient Management Group Department at Blue Shield of California.
Health Care Reform, AB 1083 and prior AB 1672 makes Employer Group Coverage GUARANTEED issue, no Pre-Existing Condition Clause, NO Medical Questions!
On the Federal Level in 1996 HIPAA was passed to include portability for an employee to be able to go from one employer’s health plan to another…  no job lock.

This caused us to lose at least one new hire, because she decided to stay on her current medical plan (with her current employer) that provides coverage for her disabled adult child.

***I suggest you appoint us as your agent and we will fill out the disabled child form, along with the employee application and get a WRITTEN answer, not a “bozo” oral – hearsay  (Federal Rules of Evidence) answer.


Proofs Required for Disabled Child
Proofs Required for Disabled Child – If you have other questions – Please post in the ask a question area below
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Blue Shield Dependent Definition - Disabled
Blue Shield Dependent Definition – Disabled


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2 comments on “Children still covered when you change to new plan

  1. I currently work for a company that provides a group health plan. I have a disabled son age 27 covered on my policy.

    I may be changing employer and going to a UC – University of California system.

    How am I able to continue coverage for him through the UC system?

    • Here’s the 2018 Health Benefits Guide for the UC System.

      Page 6 Excerpt

      If you are a newly hired employee with a disabled child over age 26 or if you acquire a disabled child over age 26 (through marriage, adoption or domestic partnership), you may also apply for coverage for that child. The child’s disability must have begun prior to the child turning age 26. Additionally, the child must have had continuous group health coverage since age 26, and you must apply for University coverage during your Period of Initial Eligibility. The plan will ask for proof of continued disability, but not more than once a year after the initial certification

      See also Page 14

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