At this time, we do know of certain changes that will be made to the AFTRA Health Plan later this year to comply with the health care reform law and regulations. Listed in this post are brief descriptions of these changes. Watch for additional details in the next Benefits Update to be published later this summer.
Dependents may remain covered until age 26
Effective December 1, 2010, children of AFTRA Health Plan participants may be covered as dependents under their parent’s Health Plan enrollment until the age of 26. However, children of any age who are eligible for coverage as an employee under their employer’s health plan will not be eligible for coverage as a dependent under the AFTRA Health Plan.
Children of participants who qualify for dependent coverage as a result of this plan change may be added as a dependent during a 30-day open enrollment period. Notification concerning this enrollment period will be sent to affected eligible individuals later this year.
Watch for additional information about the new dependent coverage rules, including details about the open enrollment period and the age-out process once a dependent turns 26, in the next Benefits Update.
Overall lifetime benefit maximums
Under the new law, overall lifetime benefit maximums will no longer be permitted. Regulations concerning this requirement were issued just days ago, and the AFTRA Health Plan’s Trustees, staff and professionals are reviewing the regulations to determine what changes will need to be made effective December 1, 2010.
Refer to the upcoming Benefits Update for additional details about changes to the Health Plan under the new law.
Pre-existing condition exclusions
The law also prohibits pre-existing condition exclusions for children under age 19, and ultimately for all ages. This aspect of the law does not apply to the AFTRA Health Plan, since this Plan does not have any pre-existing condition exclusions.