Coming soon: Special enrollment period to add or re-enroll eligible dependents

For individual health plans and group health plans that offer dependent coverage, health insurers and employers are required by the Patient Protection and Affordable Care Act (PPACA) to hold a special enrollment period to add or re-enroll dependents up to age 26 that are now eligible for coverage
under PPACA.

PPACA removes lifetime dollar limits from all health plans. Individuals who previously reached their lifetime dollar limit can also be added or re-enrolled during the special enrollment period.

Special enrollment period

Blue Cross Blue Shield of Michigan and Blue Care Network will hold the special enrollment period for individuals impacted by the provisions to extend dependent coverage and remove lifetime dollar limits from Nov. 1 through 30, 2010. This special enrollment period is only for individuals impacted by these two provisions.

The coverage effective date for enrollment is Jan. 1, 2011, with the exception of groups that have a plan year that begins between Sept. 23 and Dec. 31, 2010. In this case, the coverage effective date is the plan year start date.

If a group routinely conducts its open enrollment from Oct. 1 through Dec. 31, then the group may use its normal open enrollment period as an opportunity to enroll those impacted by the two provisions, as long as it is at least 30 days in duration. Groups with a documented plan year between Jan. 2 and Sept. 22, 2011 can use their normal open enrollment period as long as it is 30 days in duration.

Grandfathering

PPACA prohibits both of these provisions from being grandfathered; therefore all groups must hold a Special Enrollment Period in order to comply with the regulations. However, until 2014, employers who are considered grandfathered have the option of excluding employees’ adult children if they are eligible for coverage under their employer’s health plan.