OLR Bill Analysis
AN ACT CLARIFYING HEALTH INSURANCE COVERAGE FOR STEPCHILDREN.
This bill requires individual and group health insurance policies to cover stepchildren on the same basis as biological children.
The bill also makes the law that establishes requirements for coverage of children under an individual health insurance policy apply to a policy continued in Connecticut. The law already applies to group comprehensive health care plans and individual health insurance policies delivered, issued, amended, or renewed in Connecticut that cover (1) basic hospital expenses; (2) basic medical-surgical expenses; (3) major medical expenses; (4) limited benefits; (5) accidents only; and (6) hospital or medical services, including coverage under an HMO plan.
Due to federal law (ERISA), state insurance benefit mandates do not apply to self-insured benefit plans.
EFFECTIVE DATE: Upon passage
BACKGROUND
Insurance Coverage for Children
The law requires a child's coverage under an individual health insurance policy to continue at least until the policy anniversary date on or after the date the child:
1. marries;
2. ends Connecticut residency, unless he or she is under age 19 or a full-time student at an accredited college;
3. gets coverage under his or her employer's group health plan; or
4. turns age 26.
The law requires group comprehensive health care plans to (1) extend coverage eligibility to unmarried children under age 26 and (2) offer continuation coverage to the end of the month in which the child meets the criteria for losing coverage under an individual policy (listed above).
Continuation of Coverage
When a child loses coverage under a parent or guardian's group health insurance plan, he or she is eligible for continued coverage under federal law (Consolidated Omnibus Budget Reconciliation Act (COBRA)). COBRA gives certain former employees, retirees, spouses, former spouses, and dependent children the right to temporarily continue coverage under the employer's group health plan, so long as the insured pays the required premiums. The premium for COBRA coverage cannot exceed 102% of the plan's group rate for coverage, plus 2% for administrative costs.
COBRA does not define dependent. Rather, for COBRA purposes, a dependent is one who is a dependent under the terms of the group insurance plan.
Connecticut law requires employers to comply with COBRA. It also requires each group health insurance policy, regardless of the number of insured people, to provide for continuation of coverage and a right to convert to an individual policy when coverage under the group policy would otherwise cease.
COMMITTEE ACTION
Insurance and Real Estate Committee
Joint Favorable
Yea |
19 |
Nay |
0 |
(02/19/2009) |