My disabled dependent child is currently enrolled on our Health Insurance 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?

 

We find that often policyholders are told that a new insurance company  says that they will only cover disabled dependent children that are already enrolled on our group plan that happen to age out, not if you transfer plans, get a new job, etc.

Here is what we show the actual law and 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
 .
The  Group Administration Guides says virtually the same thing.
 .
Our wholesalers – General Agent’s website says:
Yes, pending approval from Patient Management Group Department
Here’s an actual EOC – Evidence of Coverage from Blue Shield for the PPO Platinum Plan.

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.

 

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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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