Dependent Coverage

The Affordable Care Act and Your Dependent

The Affordable Care Act allows for medical and prescription drug coverage for dependents until the end of the year in which they turn age 26. Note that your child is eligible for District dental plan coverage through the end of the year in which he/she turns age 23.

When your child is about to age out of the medical, prescription or dental plans, it is important that you notify the Business Office so that you can learn about continuing coverage options, such as the Health Insurance Marketplace, COBRA or New Jersey Dependent <31 coverage.

Dependents over age 26 but under age 31 may be eligible for health and prescription coverage under the New Jersey <31 Dependent law. However, you must notify the District that your dependent is no longer eligible for coverage or he/she could forfeit rights to continued coverage.

The New Jersey <31 Dependent Plan

The New Jersey <31 Dependent law gives eligible adults to age 31 the choice to elect health and prescription coverage under a parent's group health plan.

Who is eligible for the plan? All of the following conditions must be met:

* Aging-out of a group health plan

* Younger than 31 years old

* New Jersey resident or full-time-student

* Not married; not a parent

* No other health coverage

* Not entitled to Medicare coverage

* Parent is in group health coverage

What are the costs? Premium costs for your dependent plan are based on the District's current Single-tier plan. You/your dependent is/are fully responsible for these premiums. The carrier bills and collects premiums directly from your dependent.

Your dependent is enrolled as a standalone member; his/her expenses do not impact plan cost-sharing requirements or limits (e.g. family deductibles, plan maximums).

How does my dependent enroll? Those who are eligible to continue coverage under the New Jersey <31 Dependent plan must enroll within 30 days prior to losing coverage due to aging out. Others who meet eligibility at a later time (e.g., an out-of-state dependent moves back to New Jersey) may be eligible to enroll within 30 days after the event. If the 30-day timeframe is missed, he/she must wait until the next Open Enrollment period.

Eligibility ends upon the following:

* His/her 31st birthday

* Marriage or becoming a parent

* No longer a full-time student or New Jersey resident

* Gains other health coverage

* Required premiums are not paid

* The parent’s plan coverage ends or the plan ends dependent coverage

If a dependent loses eligibility but meets requirements at a later date, he/she can again elect coverage.