Topic:
CHILD HEALTH; JUVENILES; HEALTH INSURANCE; LEGISLATION;
Location:
INSURANCE - HEALTH;

OLR Research Report


December 18, 2006

 

2006-R-0791

“DEPENDENT” DEFINITION FOR HEALTH INSURANCE

By: Janet L. Kaminski, Associate Legislative Attorney

You asked for (1) information on other states' laws that increase the age at which a dependent child is no longer eligible for coverage under a parent's health insurance policy and (2) copies of testimony for Senate Bill 409 (2006).

SUMMARY

In an attempt to address the growing uninsured population of young adults, state lawmakers nationally are proposing and enacting legislation that extends dependent benefits to older children, according to the National Conference of State Legislatures (NCSL). Typically, a child loses coverage under a parent's health insurance policy at age 19, or age 23 if he is a full-time student at an accredited educational institution. (This is current Connecticut law.) Some states have passed laws that permit older dependent children to stay covered under a parent's policy (Colorado, Delaware, Massachusetts, New Hampshire, New Jersey, New Mexico, Pennsylvania, Rhode Island, South Dakota, Texas, and Utah). The laws, which vary, are summarized below and copies are enclosed.

In 2006, the Insurance and Real Estate Committee raised SB 409, An Act Establishing the Nutmeg Health Partnership Insurance Plan. The bill required insurance policies that cover dependent children to provide coverage until the child turns age 26. The committee held a public hearing on the bill and reported out a favorable substitute bill. It was not taken up by the Senate. Copies of the bill status report, the bill, the public hearing transcript, and written testimony are enclosed.

DEPENDENT AGE

Table 1 provides a summary of state laws that expand the definition of a dependent child for purposes of health insurance. Most of the information is from NCSL and may be viewed at www.ncsl.org/programs/health/dependentstatus.htm.

Table 1: States with Expanded Dependent Age Requirement

State

Law

Colorado

A child is considered a dependent for insurance purposes until his 25th birthday (even if not enrolled in an educational institution) as long as he is unmarried, financially dependent, or shares the same permanent address as the insurance provider.

Delaware

Insurance providers must cover a policyholder's dependent children until age 24. Dependents must be residents of Delaware or, if living outside Delaware, must be full-time students. Insurance companies may charge more for dependent coverage past age 18, but cannot exceed 102% of the policyholder's cost before the child turned 18.

Massachusetts

Dependents may stay on their parent's coverage for two years past the loss of dependent status age or until age 25, whichever comes first.

New Hampshire

Coverage must continue for a year for dependents who are full-time students—even if they have gotten too old for dependent status—if they have had to take a medical leave of absence from school due to injury or illness.

New Jersey

At the option of the insured person, a dependent may be covered up to age 30 as long as he has no dependents of his own. To qualify as a dependent, a person must be a plan subscriber's child by blood or law who is (1) less than 30 years old, (2) unmarried, (3) without a dependent, (4) a New Jersey resident or enrolled as a full-time student at an accredited higher education institution, and (5) not covered under any other plan. The insurance provider may charge a higher rate for this coverage, but the increase cannot exceed 3% of the premiums.

New Mexico

Health insurance for dependents may not be terminated based on age before their 25th birthday, regardless of whether the dependent is enrolled in an educational institution.

Pennsylvania

Full-time students whose studies are interrupted by service in the reserves or National Guard must be extended health care benefits as a dependent of their parent until they finish school, regardless of their age.

Rhode Island

Insurance plans which cover dependent children must cover unmarried dependent children until age 19 or, if students that are financially dependent, 25.

South Dakota

Any insurance provider offering benefits to a dependent may not terminate those benefits by reason of age before the dependent turns age 19 or, if enrolled in an educational institution, 24.

Texas

Dependent status is available until age 19 or, if full-time students, 25 or older (in some cases).

Utah

Coverage for unmarried dependents must continue until the dependent's 26th birthday, regardless of whether or not the dependent is enrolled in higher education.

JLK:ts