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Dependent child entry date under PPACA


Guest morris
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Guest morris

The group has an anniversary date of 4/1, which is the date that PPACA becomes effective for them in regards to dependent being covered to age 26. If an employee does not cover the dependent on 4/1 but decides to cover them at a later point, say 6/1, does PPACA allow them to do this?

Thanks!

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The group has an anniversary date of 4/1, which is the date that PPACA becomes effective for them in regards to dependent being covered to age 26. If an employee does not cover the dependent on 4/1 but decides to cover them at a later point, say 6/1, does PPACA allow them to do this?

Thanks!

PPACA does not change the normal rules regarding elections. Assuming the employee pays for coverage through a cafeteria plan and does not elect to cover the child in open enrollment starting 4/1, the employee may not add the child except in accordance with Code Section 125. If the employee does not pay for coverage through a cafeteria plan, the employer does not need to permit the employee to add the child mid-year (except in the case of HIPAA's special enrollment requirements, which PPACA did not change). In this latter case, the insurance contract and/or plan document will govern mid-year elections.

Note that it is not just "dependents" under age 26 that must be covered; it is "children."

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