On February 12, 2014, the IRS issued final regulations implementing the Employer Shared Responsibility provisions of the Affordable Care Act. The final regulations clarified the rules regarding a dependent’s eligibility to be covered under a parent’s health insurance until age 26. The final regulations made it clear that a child is eligible to remain on his/her parent’s health insurance until the end of the month in which the child turns 26. Most health plans, including Health New England, had interpreted this extension of eligibility to mean eligibility ended on the child’s 26th birthday.

As of June 1, we made this change for all groups. We are also conducting a manual review of all dependents who have “aged out” of their parent’s coverage since the effective date of the clarification. We will adjust the termination date for these members to the last day of the month of their 26th birthday and reprocess any claims if necessary.

Please be aware that these adjustments may result in an adjustment to a group’s monthly billing for that month if the change in the dependent’s termination date moves the subscriber into a different tier for that month. If you see retroactive adjustments to your monthly bill and are not sure of the reason for the adjustment, please contact HNE’s Accounting Department at 413.787.4000 or 800.842.4464.