Benefitsrock
Jun 23 2010, 03:38 PM
A grandfathered plan can deny an adult dependent coverage if he is eligible to enroll in an "eligible employer-sponsored health plan."
Does an "eligible employer-sponsored health plan" include a plan of which the employer is not the adult dependent's employer? For instance, if an adult dependent's spouse has health coverage due to her employment and the adult depedent is eligible to participate in his spouse's plan, can the parent's health plan deny the adult dependent coverage under the parent's plan because he is eligible to participate in his spouse's plan?
oriecat
Jun 23 2010, 03:52 PM
Sounds like it.
http://www.dol.gov/ebsa/pdf/dependentcoverage.pdfQUOTE
(g) Special rule for grandfathered group health plans—(1) For plan years beginning
before January 1, 2014, a group health plan that qualifies as a grandfathered health plan under
section 1251 of the Patient Protection and Affordable Care Act and that makes available
dependent coverage of children may exclude an adult child who has not attained age 26 from
coverage only if the adult child is eligible to enroll in an eligible employer-sponsored health plan
(as defined in section 5000A(f)(2)) other than a group health plan of a parent.