CalCPA ProtectPlus

The following information is provided by Banyan Consulting LLC:

Banyan Consulting LLC has been providing us with beneficial information about different aspects of the Health Care Reform and how it affects us. Over the next months and years, employers will be faced with numerous changes, many of which require regulatory clarification. Banyan will continue to keep us up to date and on target with decisions that affect our plans. 

There are a few pieces of the Health Care Reform Act that take effect in the near future. The one that has garnered more headlines is the requirement to cover dependent children to age 26. Click here to read the Q&A segments that address different portions of the provision and how it impacts employers.

Though not mandated to go into effect until January 1, 2011, the Group Insurance Trust has chosen to adopt early the provisions of the Patient Protection and Affordable Care Act (“health care reform”) that affect young adults. Much in the news of late, these provisions are intended to provide wider coverage at lower cost to dependent adult children up to the age of 26 regardless of student status or income. Subscribers should be aware that these changes affect medical insurance only and have no bearing on either Delta Dental coverage or their Vision Service Plan.

Historically, ProtectPlus has offered subscribers coverage of student dependents until the age of 25, if students maintained a minimum of nine units. Under the new rules, those dependents who were covered as of May 31, 2010 can retain their coverage until the first day of the month following their 26th birthday. In addition, they will no longer have to verify their student status. Those who are currently 25 years old and who were not previously eligible, or who lost their eligibility will be allowed to enroll during a special enrollment period immediately preceding October 1, 2010. Further written notification of the special enrollment period will be mailed to subscriber firms in early August.

Under the old ProtectPlus rules, dependents over the age of 19 who were not students but were dependent on their parents for at least 50 percent of their support could enroll in ProtectPlus, but were charged the single employee premium rate. Those in this category have already been folded into their parents’ coverage at the subscriber and child(ren), or family rate. Banyan Administrators has already sent a notice to this effect to benefits managers at firms with affected employees and as of June 1, 2010 premiums were adjusted to reflect these changes.

Subscribers who have children between the ages of 19 and 26 should be proactive about letting their firm benefits administrator know that they have one or more dependents who will qualify under the new rules, especially if those dependents were not previously covered. Forms to enroll these dependents will be sent out in August, so be sure to watch for them, or check online (www.cpaprotectplus.com).