In advance of this new reform requirements implementing this fall, Providence Health Plan will allow currently insured individuals age 26 or younger to remain on a parent’s employer-offered or individual and family health plan policy. This extension applies to Providence Health Plan members who currently have coverage and would lose that coverage during the gap between June 1 and the effective date of the new law, Sept. 23, 2010.
This change is effective for members of:
Reform for Employers may choose to opt-out of the early implementation of this rule. This change does not apply to Oregon Health Plan or Medicare Advantage members.
This applies only to those who would normally age-out June 1, 2010 or after, based on their policy. This change standardizes the age-out to 26 years. Unfortunately, those who aged out prior to June 1, 2010 are not eligible for re-instatement.
In order to remain on the policy, the member does not need to do anything. If they wish to disenroll, they need to contact their employer or contact Providence Health Plan directly for individual or portability plans.
For more information, read our frequently asked questions below, contact your employer benefits department or call Providence Health Plan customer service at 503-574-7500 or 800-878-4445, Monday through Friday, 8 a.m. to 5 p.m.
We recognize that extending coverage to young adults, required to take place in September, may adversely affect many adult dependents that are just graduating now, or otherwise not currently insured this summer. We hope to make it easy for these affected members to continue coverage, with minimal disruption to everyone including members and employers.
You will not have to take any action.
If the subscriber (a parent) wants to disenroll the dependent member, they will need to disenroll through their employer if it is an employer group policy or by contacting customer service for an individual or portability plan member.
No. Unfortunately, those who aged out prior to June 1 are not eligible for dependent coverage under the new reform mandate until your employer’s next open enrollment period.
The member would be disenrolled at the end of month in which they turned 26.
A grandchild cannot be added as a result of this rule on June 1; the June 1 date simply postpones the aging-out for grown children but not to add new dependent members.
A grandchild may be covered, regardless of whether their parent is covered as an adult dependent or not, if they meet the eligibility requirement as follows: A grandchild for whom the subscriber or the subscriber’s spouse provides at least 50 percent support.
A covered dependent child can be married only after the new rules go into effect, which is renewal after Sept. 23, 2010. However, a dependent child’s spouse or domestic partner is not eligible for enrollment on the policy.
That depends on the policy and benefits you have available through your parent, what the parent pays for their coverage, etc. You could instead choose to apply for a Providence individual and have your own policy. You could then stay on this plan even after age 26. This plan does subject an applicant to a health screen.
The employer would continue to cover all or part, but employers may choose to opt out of the early implementation. This extends coverage to age 26 only for currently enrolled dependents. Employers could choose not to support the early start to this implementation by sending Providence Health Plan an updated termination list of covered members. However, by federal reform law, the employers must comply with the under 26 rule at their next health plan contract renewal after Sept. 23, 2010.
No. Unfortunately, our systems do not support that.
The entire premium can be paid by credit card for all enrolled members on the individual and family plan and the portability plan, however, the members must pay the monthly bill in entirety, not just a partial payment.
Those on employer plans do not pay Providence Health Plan directly.
No.
No.
No, incapacitated dependents meeting requirements for enrollment do not have an age limit.