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Under the Affordable Care Act, a parent is allowed to extend his or her insurance to a child until their 26th year. Reliant allows its field workers to waive our medical benefits coverage when they have coverage through a parent's employer-offered insurance. If you will be turning 26 in the next calendar year, you might consider electing for insurance coverage during our Open Enrollment period in October/November. This will start your medical insurance coverage through Reliant’s plan on January 1. This may have significant financial advantages for you.

What to know

  • Like all Reliant field workers, you are required to enroll in Reliant’s medical insurance plan within 30 days of losing insurance coverage through an allowable waiver.
  • Our policies only allow you to waive until your 26th birthday. At that time, we expect you to have made your insurance election and communicated with us.
    • We will auto-enroll you in the plan with the lowest premiums unless you fill out the insurance enrollment form to let us know which insurance plan you would like.
    • In the case of a Parent's Employer's Insurance offering coverage beyond the 26th birthday, Reliant needs documentation showing the end-of-coverage from that employer. Reliant will allow waiver until the end of coverage, with confirmation of extended coverage from the parent's employer. 
  • Insurance companies vary on their cutoff points for children who age-out of their plans; you are responsible to know when that is and contact us within 30 days of loss of coverage, or before your birthday, whichever is earlier.
  • By enrolling during Open Enrollment, you will not have the hassle of finding out how your parent’s employer’s insurance interacts with this guideline.

It might cost you MORE to enroll on or after your birthday

The cost of insurance premiums are just one portion of your medical costs. When someone changes insurance mid-year, they also have to restart the clock on their deductible. For you that means that medical expenses you incurred prior to being enrolled in Reliant’s plan don’t count toward the deductible on your new insurance plan. We believe it may be a burden for some field workers to cover one deductible under their parent’s employer-offered plan and then have to meet their own deductible starting mid-year.

Steps to take

  1. Consider enrolling with Reliant's medical insurance during the Open Enrollment period.
  2. If you will be staying on your parent’s employer-offered insurance until your birthday, you will need to fill out a waiver form. Please send your completed waiver to benefits@reliant.org.

Questions?

 Jennifer Greening

Email:   benefits@reliant.org

Phone: 407-630-5904

Title: Benefits Coordinator

Department: Employment Services


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6 Comments

  1. Unknown User (ed.courtney@reliant.org)

    Tonya Bartels Unknown User (emmanuel.joseph@reliant.org) user-1a794 Kathy Zellinger KZ sent me an earlier email asking for a page based off the email HR typically sends out. Here's a shot at it. Feel free to edit, etc, and let me know if it's something we want in the Field Manual.

  2. user-1a794

    Unknown User (ed.courtney@reliant.org) I"ve just made edits and ready to see this moved to the Field manual and fully published. 

  3. user-1a794

    Dave Meldrum-Green

    please re-read this email from Janet Stebbins.  Loss of covereage is the real event.  Since we allow waivers, we must accept if parent employer insurance allows coverage until the end the calendar year. 

  4. user-1a794

    11/11/2016 - copied from email: 

    Hi Cori,

    I think there would still be a concern with bringing these people onto the plan before their special enrollment period actually occurs.  The actual qualifying event which triggers the special enrollment period is the loss of coverage under their parent’s plan.  I appreciate that you are trying to make sure that no one is overlooked during the course of the year. The auto-enrollment idea might still work but I would recommend that Reliant documents a communication to the employees informing them of the auto-enrollment process and giving them an opportunity to show proof of parental coverage through the end of the year in order to delay/cancel auto enrollment. If push came to shove and someone failed to produce that documentation until after they had been auto-enrolled, it would probably be better from a compliance standpoint to terminate their coverage and re-enroll them when they actually lose coverage under their parent.

    The bottom line is that Reliant is fulfilling it’s obligation under the Employer Mandate by offering the coverage.  If the employee fails in their responsibility to inform Reliant of a qualifying event, there is no penalty to Reliant.  There is some middle ground in there as far as wanting to make sure your people have coverage and come into the plan as soon as possible without forcing them on at the outset of their employment but once your policy is to allow a waiver if they have other coverage, you have to be careful to keep that policy applicable to everyone all the time and that special enrollment rules are being followed. 

    Please let me know if you have any further questions.

     

    Janet Stebbins

    Compliance Consultant & Benefit Analyst

    Marsh Consulting Group

    2626 Summer Ranch Road

    Paso Robles, CA 93446-8473

  5. Thanks Cori. This is helpful. Janet's email was specifically in regards to our proposal of doing an "auto enroll plan" for people turning 26. Though she mentions this phrase.....when they actually lose coverage under their parent.....her email does not really address the main issue of what happens when the person turns 26. So.... I have researched the government's website: https://www.healthcare.gov/young-adults/children-under-26/ and found this section....

    • If you’re covered by a parent’s job-based plan, your coverage usually ends when you turn 26. But check with the employer or plan. Some states and plans have different rules.

    Thus, I am fine with someone turning 26 and remaining on their parents job-based health plan if their coverage extends until December 31. But we still need to offer them group coverage through Reliant at age 26 as well. Then during Open Enrollment, they will obviously need to join Reliant's plan. 

     

  6. Unknown User (ed.courtney@reliant.org)

    user-1a794 This has been moved to the Field Manual.