Amwins Connect - August Question of the Month

Amwins Connect - Question Of The Month August 2023

Question:

When a covered employee’s dependent child attains age 26, when can the Group Health Plan terminate the dependent's coverage?

Answer:

It depends!

Group Health Plans that offer dependent coverage are required to continue to make coverage available for an employee’s child until the child’s 26th birthday. This is required no matter where the child resides, financial dependence, student status, employment, or other factors. For example, let’s say the employee’s child birthday is July 10. The group health plan only needs to offer coverage for the child through the day before his or her 26th birthday, July 9.

However, if the employer/company offering group health coverage is an applicable large employer (ALE) under ACA guidelines, the employer could face potential employer shared responsibility penalties if they do not offer coverage to the employee’s child through the last day of the month the child turns age 26. Using the same example in the above paragraph, coverage must be offered through July 31 to avoid penalties for the ALE.

There are a few states that allow or require dependents to remain covered past age 26.

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