You asked whether our law requires health insurers to provide dependent coverage until they attain age 26.

SUMMARY

Our law does not require health insurance policies to cover an insured's children until the children attain age 26. But our law will require this for individual and group policies effective January 1, 2009.

Under current law, individual policies that offer family coverage and group policies must insure dependent children at least until the policy anniversary date on or after the date the child (1) marries, (2) ceases to be a dependent of the policyholder, or (3) attains the age of 19 if he or she is a part-time student or age 23 if he or she is a full-time student at an accredited institution.

Two acts that the legislature adopted in 2007 change this law by requiring that these policies cover an insured's children until they are 26 if they (1) reside in Connecticut, (2) attend an out-of-state accredited institution of higher education full time, or (3) reside out-of-state with a custodial parent pursuant to a child custody determination. Also they eliminate the requirement that the child be dependent. The first act (PA 07-185) makes its changes effective in 2007 but the second act (PA 07-02 June Special Session) amended the first act and made the changes effective in 2009 instead.

Following is a summary of each of these public acts.

PA 07-185—SB 1484 AN ACT CONCERNING THE HEALTH FIRST CONNECTICUT AND HEALTHY KIDS INITIATIVES

The act raises, from age 23 to 26, the age to which group comprehensive and individual health insurance policies that cover children must do so. Prior law required coverage for unmarried, dependent children until they turn 19, or 23 for full-time students at an accredited school. The act eliminates the requirements that children be dependent or full-time students and limits the continuing coverage to those who live in Connecticut.

The act applies to:

1. individual health insurance policies delivered, issued, amended, or renewed on or after October 1, 2007 that cover (a) basic hospital and medical surgical expenses; (b) major medical expenses; (c) accidents; (d) limited benefits; and (e) hospital or medical services, including HMO contracts and

2. group comprehensive health care plans (a minimum plan all health insurers must offer) beginning July 1, 2007.

PA 07-2, JUNE 2007 SPECIAL SESSION— HB 8002 AN ACT IMPLEMENTING THE PROVISIONS OF THE BUDGET CONCERNING HUMAN SERVICES AND PUBLIC HEALTH

The act amends provisions in PA 07-185 that raise, from age 23 to 26, the age to which group comprehensive and individual health insurance policies that cover unmarried children must do so. That act limited the coverage extension to children who reside in Connecticut; this act specifically extends coverage to full-time students attending accredited out-of-state colleges and universities and children who live out-of-state with a custodial parent pursuant to a court order.

It makes both the group and individual policy coverage provisions effective January 1, 2009. PA 07-185 made the group provision effective July 1, 2007 and the individual policy provision effective October 1, 2007.

GC:ts