Maryland’s Family Coverage Expansion Act (House Bill 1057) passed effective Jan. 1, 2008, which requires insurers, HMO’s and nonprofit health service plans to allow unmarried children to remain on their parent’s health plan until age 25, regardless of student status. This provision does not apply to Maryland Small Group Reform plans. The law does not require employers to provide dependent coverage, but if they do the age is extended to 25. The definitions of a dependent child are expansive but generally the dependent must be (a) a natural child, stepchild, adopted child (or placed for adoption) or grandchild, (b) must have the same residence for more than half the calendar year (living at college under the definition of dependent for tax law also counts), (c) must not be married and (d) must not have provided more than half their own support for the previous calendar year. Foster children are not eligible.

According to the U.S. Census Bureau, young adults, those between the ages of 19 and 34, are the fastest growing uninsured population in the U.S. Many states, including Maryland, have enacted legislation extending dependent benefits to older children. In the past, full-time students were eligible for heath insurance benefits under a parent until graduation or usually age 25. Dependents over the age of 19 who were not full-time students typically lost all health care coverage. Under the new legislation MD Code, Insurance Section 15-418 requires that “health insurance be extended to, at the request of the policy holder, those that are unmarried, under the age of 25 and living with their parents.” Chapter 395 states that “an insurer who provides coverage to dependents 18 or older who are enrolled in higher education full time may not cut off coverage to dependents of the same age if they are only in school part time due to a documented disability.” Dependents of federal employees or retirees are an exception to these rules. At age 22 they are no longer eligible for coverage under a parent’s plan. Only unmarried children who are incapable of self-support because of an incapacity that began before attaining age 22 are eligible for coverage regardless of age if they are covered under a parent who is/was a federal employee.

The State of Maryland in 2007 passed the Family Coverage Expansion Act (Maryland House Bill 1057), which was designed to extend health benefits to a larger class of child dependents by changing the eligibility class to accommodate unmarried children under the age of 25, regardless of student status. This new law does not apply to groups enrolled under Maryland Small Group Reform. These provisions became effective Jan. 1, for new accounts and upon renewal beginning Jan. 1, for existing accounts, and apply to Maryland HMO and indemnity fully insured groups. The law only applies to those companies that offer dependent coverage which companies are not obligated to offer. However, if they do offer dependent coverage the new rules apply. If the child had been removed from the policy prior to this new law and is still under the age of 25 they may re-apply to be added back to the policy. The child may stay on the policy unless removed voluntarily until the end of the month in which they turn 25. A dependent is generally defined as a natural child, stepchild, adopted child, or grandchild of the Subscriber or the Subscriber’s covered spouse; a child (including a grandchild) placed with the Subscriber or the Subscriber’s covered spouse for legal adoption; a child under testamentary or court appointed guardianship, other than temporary guardianship for less than 12 months duration, of the Subscriber or the Subscriber’s covered spouse; or a child who is the subject of a Medical Child Support Order or a Qualified Medical Support Order (“QMSO”) that creates or recognizes the right of the child to receive benefits under the health insurance coverage of the Subscriber or the Subscriber’s covered spouse.