Does the Health Care Reform legislation require broader dependent coverage?
April 12, 2007Q: Does the recently enacted Health Care Reform legislation require broader dependent coverage? What will the impact be on cities and towns?
A: The Health Care Reform legislation (Chapter 58 of the Acts of 2006 as amended by Chapter 324 of the Acts of 2006) amended chapters 175, 176A, 176B and 176G of the General Laws to require a broadening of dependent coverage offered by health insurance carriers. Collectively, the amendments require that, on or after January 1, 2007, carriers issuing or renewing insured (premium-based) health benefit plans with dependent coverage make coverage available for persons through the earlier of the person’s twenty-sixth birthday or two years following the person’s loss of dependent status under federal tax rules. Thus, municipal employees who receive their health coverage through insured (premium-based) plans will be subject to that expanded coverage of dependents, since the insurers who provide premium-based health coverage will be mandated to make that expanded coverage available.
The Massachusetts Division of Insurance has expressed the opinion, however, that the new definition of dependent does not apply to self-insured health plans, including municipal self-insured plans. This is because the chapters that include the new definition apply to insurers that are regulated by the Division of Insurance, but do not apply to employers who offer their own self-insured plans.
Answer provided by Paul Mulkern, an attorney who represents municipalities in the area of labor and employment law.
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