OPM releases guidance on dependent children coverage for 2011

The U.S. Office of Personnel Management released guidance to plan carriers today on how the Affordable Care Act changes dependent child coverage rules in the FEHB Progam generally “effective January 1, 2010.” Currently, at a high level, the FEHB Act provides for coverage of unmarried dependent children up to age 22 if the employee or annuitant enrolls for self and family coverage. Here is a summary of the major Affordable Care Act changes outlined in the carrier letter:

  • Children between the ages of 22 and 26 are eligible for coverage under their parent’s Self and Family enrollment up to age 26.
  • Married children (but NOT their spouse or their own children) are eligible for coverage up to age 26. This is true even if the child is currently under age 22.
  • Children who are eligible for or have their own employer-provided health insurance are eligible for coverage up to age 26.
  • Stepchildren do not need to live with the enrollee in a parent–child relationship to be eligible for coverage up to age 26.
  • Children who are incapable of self-support because of a mental or physical disability that began before age 26 are eligible to continue coverage.
  • Beginning January 1, 2011, to add a foster child to a Self and Family enrollment, the foster child must be placed with the enrollee by an authorized placement agency or by judgment, decree or other order of any court of competent jurisdiction.  [OPM] will provide information on the coverage of current foster children in a future carrier letter.