Boca Benefits Consulting Group Inc.

Yesterday I read the results of a survey conducted by a large national HR consulting company which indicated that only 16% of employers intend to implement the “To Age 26” provision of PPACA early to accommodate graduating college seniors. Most existing plans, which are “grandfathered” by definition (i.e., in existence on March 23, 2010) will defer making the offering until the first anniversary/plan-year date following the mandatory statute date of September 23, 2010.

The Impact

1. Many graduating college seniors will not be eligible until January 2011 when the majority of plans have plan-year dates.
2. Some will have to wait even longer if plan-year date is later than January 1st.
3. Some could have to wait as long as August 2011 if the plan has an odd summer/fall plan-year date.
4. Same goes for other “adult children” up to age 26 who thought they would become eligible immediately.

BBCG brokers permanent individual coverage. However, we also have short-term temporary coverage for this type of situation. If you know anyone who falls into the above categories, please have them go to http://bocabenefits.com/ind_health.htm where they can access a self-directed quoting service from United Healthcare’s “UnitedHealthOne” (f/k/a Golden Rule) products. The second screen following the initial zip code screen allows for selection of the short-term product.


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Below is link to excellent National Association of Insurance Commissioners “Frequently Asked Questions” resource relative to the specfics of PPACA (i.e., 2010 health care reform statute). It is segmented by Consumers, Employers and Seniors.

Click here for link.

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CIGNA is hosting an educational teleconference on the subject of early implementation of the “To Age 26” provision of PPACA. Valuable for all employers sponsoring employee health plans (i.e., both insured and self-funded). Possibly broker and CIGNA client oriented. However, pertinent to all regardless of present carrier and/or TPA.

CIGNA teleconference registration link.

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Below are two links to resources provided by the U.S.  Department of Health and Human Services in regard to the new “To Age 26” provisions of PPACA. Important reading for graduating college seniors, parents and other adult children less than 26 years of age.

HHS Frequently Asked Questions

HHS fact sheet

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United Healthcare announced that it has agreed to the White House’s request to provide coverage for graduating college seniors under the “To Age 26” provision of PPACA (i.e.,  2010 health reform act). See below excerpt from announcement. Click here for full broker announcement.

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On April 19 we (sic) announced that we will work with customers that wish to extend the health coverage that graduating college students currently have under their parents’ plans. As a result, we are mailing letters beginning May 5 to all fully insured customers* regarding our graduate coverage initiative.  The mailing includes the Customer Notice, Letter and FAQ and Opt-Out form posted above.

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Following on CIGNA’s earlier announcement this week regarding early implementation of the PPACA “to age 26” provision, CIGNA has announced today that they will also implement early the “anti-rescission” provisions of PPACA prior to the statutory requirement of 9/23/2010. CIGNA has announced they will make the policy change effective 5/1/2010.

It would appear that CIGNA is attempting to capture the public relations high ground on these decisions relative to their healthcare insurance competitors. However, these are relatively easy changes to effect and will not substantially alter the competitive balance as other major carriers make similar decisions to implement certain PPACA provisions early.

Below Excerpt from CIGNA Press Release:

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CIGNA’s business practices are already compliant with the suggested reforms that are to be implemented on September 23, 2010. CIGNA is confirming that it will not rescind the coverage of any premium-paying customer except in cases of deliberate fraud or intentional misrepresentations of material facts. CIGNA will also institute a policy of third party review if a rescission is to be made.

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Click here for full press release.


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Below from The White House Blog. See http://www.whitehouse.gov/blog/2010/04/27/more-support-young-adults for a list of carriers voluntarily accelerating the “age 26” provision to make in coincide with 2010 college graduation dates as of the date of this posting. BBCG expects that most all carriers will ultimately agree to this timeline.

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But we knew that some young adults graduating from college this spring could risk losing their health insurance before the provision takes effect, only to be added back onto their parents’ policy the next time their parents’ plan comes up for renewal on or after September 23rd.  That was bad news for families and bad news for insurance companies too.  Removing an individual from a health insurance plan and then adding them back on a few months later takes time, and it costs money.

That’s why on April 19, Health and Human Services Secretary Kathleen Sebelius called on leading insurance companies to begin covering young adults voluntarily before the September 23 implementation date required by the new health reform law.  Early implementation would avoid gaps in coverage for new college graduates and other young adults and save on insurance company administrative costs of dis-enrolling and re-enrolling them between May 2010 and September 23, 2010.   Early enrollment will also enable young, overwhelmingly healthy people who will not engender large insurance costs to stay in the insurance pool.

And we’re pleased to report that the following insurance companies are doing just that:

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We have received communications from both CIGNA and Aetna that they will each be implementing the “to age 26” provisions of the Patient Protection and Affordable Care Act earlier than required by statute (9/23/2010).  The concern stated is the potential for a gap in coverage for those in the 21-26 age group who may be graduating from college and who would otherwise lose eligibility once full-time student status was eliminated.

Both companies are making their eligibility changes effective 6/1/2010.

Although we have not seen announcements from either Blue Cross/Blue Shield or United Healthcare, BBCG is surmising that the changes announced by Aetna and CIGNA have become the new de facto eligibility standard and that the other major healthcare insurers will follow.

Click here for CIGNA announcement. 

Click here for Aetna announcement.