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OPM works with Congress to speed health coverage for adult children

Apr. 26, 2010 - 06:00AM   |  
By STEPHEN LOSEY   |   Comments
The caduceus
The caduceus (BRYAN SMITH / STAFF)

The Office of Personnel Management is working with Congress to implement the health reform law early by allowing health insurance coverage of employees' adult dependent children up to age 26 before Jan. 1. If current laws are not changed, however, dependents age 22 and older will have to wait until 2011 for coverage.

Some health insurance providers plan to extend coverage to adult dependent children of their non-federal enrollees early. Blue Cross Blue Shield last week said that beginning June 1, it will extend coverage for most enrollees' adult children who are under age 26.

The health care reform law requires insurers to extend coverage to enrollees' children in the first plan year beginning on or after Sept. 23.

Kaiser Permanente, Humana and other insurers are also extending coverage ahead of schedule.

But the Office of Personnel Management said April 23 that the current law governing the Federal Employees Health Benefits Program does not allow federal plans to cover enrollees' children before the health care reform provisions take effect.

Current FEHBP law defines family members as "an unmarried dependent child under age 22." OPM said in a statement posted online that it is working with Congress to try to change the definition of a family member. If that definition is not changed, dependent coverage will extend on Jan. 1, 2011 the first day of the next plan year.

"Though we are eager to provide coverage to young adults prior to January 1, the current law governing the FEHB Program specifically prohibits us from doing so," OPM said.

In the meantime, OPM said that adult dependent children will retain their coverage for 31 days after they turn 22. And a family can receive up to 36 months of additional coverage under the Temporary Continuation of Coverage program. But temporary coverage is more expensive the federal government does not cover any part of the premium under that program.

The Obama administration last week lauded those insurance providers who are broadening their coverage before the deadline.

"We're gratified to see so many agreeing to do so and we know that thousands of young adults and their families are, too," Communications Director Dan Pfeiffer wrote on the White House blog April 20. "It's the right thing to do."

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