Page 1

may | 2010 | edition 005

shirazi NOTICE

Count on Shirazi Benefits to deliver your inbox with expedient and worthwhile news.

DEPENDENT COVERAGE EXTENDED As you know, President Obama signed into law H.R. 3590, the Patient Protection and Affordable Care Act last month. One important change to your health care coverage will be the ability to have your dependents covered until they are 26 years old. This effort is to fill the coverage gap between June and September 23 when the provision in the health care reform legislation will take effect. Please note that for ALL carriers, early coverage is not extended to adult children who are currently not covered under the group plan. This includes adult children currently covered by COBRA. (Enrollment of these dependents up to age 26 can take place during the next renewal period after September 23, 2010.) All our carriers have decided to make this change effective sooner than the September 23, 2010 required date. Below is a breakdown of when the change is effective for each carrier. More detailed information regarding each carrier can be found on page 2.



Effective June 1, 2010 - no action required by client.

Effective June 1, 2010 - no action required by client.

CIGNA/Great West ASO Self-Funded

Rocky Mountain


Effective June 1, 2010 and client must opt-in to extend coverage.

Effective immediately - no action required by client.

Effective immediately - no action required by client.

contact us | | 970.356.5151

page 1

page 2

Beginning June 1, Anthem will continue to provide health benefits to dependents who - because of their age, student status or other factors - would lose coverage during the gap period between June 1, 2010, and the September 23, 2010, effective date. This extension of coverage will not be retroactive; however, dependents that aged out before June 1, 2010, can be added back onto a parent's policy during the group's next open enrollment period on or after September 23 in accordance with the new law. ASO and most accounts with 100 or more employees have the option to not offer this extended coverage.



The new regulation requires plans to extend dependent coverage to age 26. Employers and other plan sponsors that are self-insured are responsible for establishing the eligibility requirements for their plans – CIGNA/Great West administers these plans according to the provisions the employer establishes. For our ASO Self-Funded groups, they will be allowed to "Opt-In" to the Dependent Coverage Increase to age 26. There will be no rate impact. Self-funded clients must opt-in for this extended coverage. To opt-in, clients must provide notice to extend coverage in writing. Extended coverage will be effective on the first day of the following month after client notification is received. For clients opting-in, extension of coverage to current enrollees is automatic and no action is required by employees. Clients who are extending coverage will need to inform current and new employees of the extended dependent coverage up to age 26. If a client chooses not to opt-in, the PPACA Dependent Care Coverage Extension to age 26 will take effect on their first plan anniversary after September 23, 2010 for those dependents without other available employer coverage.

Your team at Shirazi Benefits will be providing further correspondence to those CIGNA/Great West groups with a templated letter you may provide to them to opt-in.


UnitedHealthcare wants students to graduate into a secure future, not the ranks of the uninsured. UHC is extending coverage for graduating college students under the age of 26 who are currently enrolled in their parent’s plan with UHC. Graduating students in other carriers’ health plans are not eligible. UHC is not offering this extension of coverage to other young adults who may be losing dependent coverage before the new federal requirement takes effect. This is an extension of the coverage that is already in place for college students who are enrolled as dependents under their parents’ health plan, so the cost sharing and enrollment qualifications remain the same.


Current dependents under the age of 26 would not have to leave their plans when they would otherwise age out or are no longer full-time students (including those who would have lost eligibility effective May 31, 2010). Aetna will continue coverage effective June 1, 2010 for dependents under age 26 currently covered on a parent’s medical plan.

Effective immediately, Rocky Mountain Health Plans is extending coverage up to age 26 for dependent children who are currently enrolled in a SOLO or fully-insured group plan. Dependents under the age of 26, eligible under RMHP's current eligibility criteria can remain insured with no gap in coverage before the new federal requirements take effect. New employer groups and SOLO Members enrolling with RMHP between May 1 and September 30, 2010, will also benefit from this extended age limit. Dependents must meet all other applicable RMHP current eligibility criteria to qualify. On October 1, 2010, RMHP will open enrollment to adult dependents in accordance with federal requirements. At that time, we will also hold a 60-day open enrollment period to eligible dependents not previously covered.


© 2010 Shirazi Benefits, LLC. All rights reserved. This publication is intended for general information purposes only. It does not constitute legal advice. The reader should consult with knowledgeable legal counsel to determine how applicable laws apply to specific facts and situations. This publication is based on the most current information at the time it was written. Since it is possible that the laws or other circumstances may have changed since publication, please call us to discuss any action you may be considering as a result of reading this publication.

Shirazi Notice 005  

As you know, President Obama signed into law H.R. 3590, the Patient Protection and Affordable Care Act last month. One important change to y...

Shirazi Notice 005  

As you know, President Obama signed into law H.R. 3590, the Patient Protection and Affordable Care Act last month. One important change to y...