What, if any, is the typical practice, across the board, from insurance company to insurance company, in regard to a minor child who is insured under his parent's health care plan, when he reaches the age of 18; (If he still resides at home, and has not started college yet)? Is he still eligible for coverage under the plan? If so, until what age is he eligible, and does he have to be going to school during that time. And if so -- does it have to be full-time, or is part time enough?
Well, it depends on if he/she was covered under a large group or small group (under 50 members) plan. If it was a large group, the company providing the benefits is allowed to define eligibility for a dependent and when they are no longer eligible for coverage. Most large groups require dependents to be full time students if they are over 18, and usually, they are required to come off the plan as of the last day of the month of the 19th birthday if they are NOT full-time students. However, if the child is a full-time student or is enrolled to become a student during that same year, the insurance carrier will typically require proof of that and let the child stay on as long as they are a full-time student, usually until the last day of the month that they turn age 25. It's always a good idea to call the number on the back of your insurance card to double check when the child is going to be removed from coverage. The customer service representative should be able to give you that information, especially if the child is approaching his/her 19th birthday.
If it is a small group plan (less than 50 members in the group), then, by Colorado health insurance law, the child can remain on the plan until the last day of the month that they turn age 25 IF they are a full-time student, not a student, but still financially dependent upon the parent or or if they live in the same house as the parent. Again, the insurance carrier will typically require proof of financial dependency to be sent in, in order to avoid the child being automatically removed from coverage as of the last day of the month that he/she turns 19 years old.
In either case, the Colorado insurance carrier will typically send out some kind of notice to forwarn you of the pending termination of coverage and what you need to do in order to have the child remain covered.
"if he is discontinued when he turns 19 because he's not in school, will the insurance carrier allow him to "come back on" when he finally does enroll."
That's a good question, because I know that they will let him re-enroll once he becomes a full-time student. However, what I'm not sure of is if becoming a full-time student will count as a qualfiying event or not. If it does, he will be able to come on right away, but if it doesnt, then they could make him wait until open enrollment to come on the plan. When you call the insurance carrier, you should ask if the date he becomes a full-time student will count as a "qualifying event". If it does, then they will let him enroll as of the date he becomes a full-time student. If it doesn't, then he will have to either wait until first of the month following the application for enrollment or until "open enrollment". This is something that you would want to either ask the insurance carrier or your HR manager.
