Changes to PA and NY Health Laws: Age 29 and COBRA
Some interesting changes to Pennsylvania and New York health insurance laws have come through recently that warrant some attention. They deal with the extension of coverage through age 29 and also the extension of continuation coverage as a whole.
First, Pennsylvania. Effective June 10, 2009, Pennsylvania allows for adult children to retain coverage under their parents'' health plan up to age 30 (or through age 29). Unmarried children who have no dependents, are residents of PA or are full time students are eligible for this extension. The extension of coverage is at the option of the employer and does not preclude an increase in premiums for employers who elect the extension coverage. Insurers writing policies or renewals after December 7, 2009 (180 days after the effective date of the law) are obligated to offer the extension coverage and employers may elect to include the coverage. It applies only to medical coverage, not to vision and dental. Self-funded plans are exempt. Because employers are not mandated to make the coverage available, and because the extension could increase overall premiums for the employer, we will have to watch to see how many employers actually implement the coverage.
Second, New York. Effective July 24, 2009, New York requires commercial insurers providing group health coverage to extend an option to continue group health coverage to unmarried children who have "aged off" of their parents' group plan. Adult children can maintain the coverage through age 29 provided they are not eligible for other employer coverage and are not covered by Medicare. Employers are not required to pay the premiums for the adult children who elect this coverage, so the election is entirely at the discretion of the adult child and not controlled by the employer. This law is apparently directed at insurers only and will not require employers to make any specific election.
Third, New york again. This one is a little trickier and will require further clarification. Effective July 1, 2009, commercial insurers offering group health policies are required to offer continuation coverage for 36 months. This extension would allow employees or members who have otherwise exhausted federal COBRA to maintain coverage for up to 36 months if the COBRA benefits did not extend to that full 36 months. This bill allows workers, regardless of the size of their employer, to extend coverage to the full 36 months by returning to state continuation coverage after federal COBRA has been exhausted. Eligible participants have to pay the premiums but their experience may impact the overall rating for employers. This additional 18 months should not be subject to the federal COBRA subsidy regulations. Again, as a new law, we will have to watch for the actual impact, but for now it looks like after the 18 months of COBRA is exhausted, the participant could continue to obtain an additional 18 months of continuation coverage on their former employer's New York insurance policy.
We will continue to monitor these new laws and update employers on the impact and any guidance issued. However, employers in New York and Pennsylvania should make themselves aware of these changes and be prepared to seek counsel if employee ask questions about how they can take advantage of these options.
