Benefits Continuation: Young Adult Option

Effective Date: November 1, 2009

Function: Office of Human Resources

Contact: Timothy Orcutt

Basis of Procedure

Chapter 240 of the New York State Laws of 2009, sometimes called the “Age 29” law, permits eligible young adults through the age of 29 to continue or obtain coverage through a parent’s group policy.

Click the link to read more about the "Age 29" law.

Procedure Summary

This procedure explains how to administer the continuation of benefits after a young adult reaches the limiting age for coverage under the parent’s plan.

Procedure Steps

For dependent children who have reached, or are nearing, the limiting age:

Step

Responsible Party

Action

1

Health Plan

Notifies the employee of the dependent child’s right to continue benefits at least 60 days prior to losing coverage based on age.

2

Campus Benefits Administrator

After being contacted by the employee or dependent child, mail the following documentation to the dependent child at his or her own address:

3

Young Adults

Return completed forms to:

The Research Foundation for SUNY

Benefits Services Unit

35 State Street

Albany, NY 12207

4

Benefits Services Unit

Provides billing information to CONEXIS

5

CONEXIS

Processes and maintains the continuation of benefits

Definitions

The following terms are used in this procedure.

Term

Definition

Young Adult

A child of an employee enrolled in RF health coverage who meets the following criteria:

  1. Unmarried;
  2. 29 years of age or under;
  3. Not insured by or eligible for comprehensive (i.e. medical and hospital) health insurance through his or her own employer;
  4. Lives, works or resides in New York State or the health insurance company’s service area; and
  5. Not covered under Medicare.

    Note: The young adult does not have to live with a parent, be financially dependent on a parent, or be a student.

     

Related Information

Eligibility for Continuation of Coverage

Dependent children covered under the parent’s RF health insurance plan are eligible to continue coverage after reaching the plan’s limiting age.

Eligibility When There is a Change of Circumstances

Children may also enroll under their parent’s RF health insurance plan within 60 days of newly meeting the eligibility requirements. Coverage will be prospective and will start within 30 days of when the RF receives notice of your election and premium payment. Examples of changes in circumstance would be a young adult moving back to New York State after living outside the state or losing health insurance coverage sponsored by another employer.

Cost of Coverage

The young adult or his/her parent is responsible for paying,

Under...

the..

COBRA

single rate full premium plus 2% administrative charges

NYS Young Adult Option

single rate full premium

Effective Dates of Coverage

The effective date of coverage will be determined by when the young adult elects the continuation coverage:

The effective date of...

is retroactive to the date the dependent was no longer eligible under the plan if...

or the first day of the month following RF receipt of election form and premium if...

and is terminated when the...

COBRA

the election form is received within 60 days of the date the election form is sent to the participant

(not applicable)

dependent becomes covered by another group health plan, OR

dependent becomes entitled to Medicare (whether or not they enroll in Medicare)

NYS Young Adult Option

the election form is received within 60 days of losing eligibility under the parent's plan

received during the annual open enrollment period which takes place November 1-30 of each year

 

parent is no longer employed by the RF and covered by an RF health plan, OR

dependent no longer meets all of the criteria for the definition of "Young Adult"

Related Resources

Below are related resources to complete the procedure or that provide other relevant information or instructions.

Resources

New York State Young Adult Option, New York State Insurance Department

Young Adult Notification Form - Loss of Insurance Coverage Notice

Young Adult Notification Form - Insurance Coverage Election Notice

Election and Eligibility Forms - COBRA Continuation Coverage Election Notice
COBRA Continuation Coverage Election form (included with the Notice)

Election and Eligibility Forms - Young Adult Dependent Election and Eligibility form

COBRA and Young Adult Rates

Change History

Date

Change History

December 13, 2013

Changed Wageworks to CONEXIS and reformatted to template

October 26, 2012

Changed FBMC to WageWorks

May 7, 2012

Updated links and FBMC address

December 8, 2011

Corrected broken and outdated links

January 3, 2011

Removed outdated language and added clarifying statement on enrollment.

December 17, 2009

Updated links and format.

November 1, 2009

New Document.

Copyright © 2009 The Research Foundation of State University of New York

 

 

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Copyright © 2011 The Research Foundation of State University of New York