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California health insurance    Guide to California health coverage    Dependent Children and California health plans

Dependent Children and California Health Insurance

Dependent children are able to remain on an adult's policy in a subscriber/child, subscriber/children, or subscriber/family make-up. This can be beneficial both in terms of monthly premium and/or benefits for California health insurance plans so let's understand a little better how coverage for dependent children is treated.

First, What Defines A Dependent Child?

This definition has changed since we originally wrote this article due to passage of Health Reform and we applaud the change since the old age (18) caused issues for college students and did not reflect the reality of young adults age 18-25. A dependent child in terms of health insurance is a minor age 0 to 25 (till 26th birthday following Health Reform changes) who is under the policy of an adult.

There is no longer a requirement that the dependent be a full time student in order to stay on the parent's plan as a dependent.

What happens when a dependent child can no longer remain on the adult's health insurance policy?

If the policy is a California individual family health plan, the over-age child can usually be split off onto his/her own policy with the same coverage as the parent's plan most major carriers. This makes sense since you can usually split family policies in the case of divorce, etc. Medical is no longer required for individual/family health insurance.

It does make sense to re-evaluate the child's situation to see if they can qualify for a tax credit through Covered California. 

We can quickly establish what is available (especially subsidies) by phone at 800-320-6269

If the policy is a Small Group health plan, the dependent should be able to get Cobra for at least 18 months and perhaps up to 36 months with a Cal-Cobra extension regardless of health. This assumes that the group plan stays intact. If a dependent child is in good health, it usually makes sense to run an individual health insurance quote as an alternative to the Cobra option but a dependent never wants to exhaust his/her cobra election period without having other health insurance coverage firmly in place. Cobra tends to be more expensive (albeit for richer benefits) so individual health plans may offer a good alternative.

Losing group health insurance is a qualifying event to enroll in Covered Ca at any time

Again, never drop coverage until written notification of approval from the carrier for a rate and plan you want.

What are the benefits to keeping children on as dependents?

With a group health plan, the benefits to keeping children on the adult parent's plan is obvious if the employer is paying all or a percentage of dependent coverage. The company is subsidizing the dependent coverage and therefore, it is usually hard to find a better value on the individual health market. Some carriers will apply one dependent rate for multiple children. If the oldest child is within the 19-26 age, it would be advantageous to keep him/her on the family plan since the rate is the same with or without his older child for certain carriers. Otherwise, you or the company would have to pay the family rate plus an individual health plan for the overage dependent child. Individual/family plans no longer present the same benefit for multiple children under a flat "family rate".

If a child is on a group plan and has health issues, medical underwriting is no longer required for individual/family enrollment.

Dependent coverage versus college plans

Another consideration is whether it makes sense for a dependent child to go with a college health plan or remain as a dependent. Aside from the premium effect mentioned above, it's important to compare apples and apples in terms of coverage. There are benefits and costs to college plans so it's important to understand and compare them thoroughly. College plans are probably going to phase out over time due to Health Reform constraints.  We're happy to help you compare the options.  You can find more information on college plans here.
Related Popular Pages:
Important changes for California Health Reform
Cobra versus Individual health insurance

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