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Employer Update | July 2016
Employer Update | July 2016

Is Your “Kid” Turning 26 this Summer?

During these warm weather months, we’ll see more kids aging off of their parent’s health insurance coverage than any other time of the year. That’s because, according to the National Center for Health Statistics, the months of July, August and September are the most popular for births.

Thanks to the Affordable Care Act, children up to age 26 can be covered under their parents’ health insurance. That’s the good news! The bad news is once they age off of their parent’s policy, many are left without the safety net of having health insurance. They may not have an employer who offers coverage, or they may not be able to afford the Bronze, Silver, Gold or Platinum plans available to individuals. Fortunately, there’s a third option: Your kids who turn 26 this summer may qualify for the new $0 or $20 a month Essential Plan.

Those who are eligible for the Essential Plan can enroll whenever they turn 26 through the NY State of Health marketplace. Eligibility is based on household size and income. The Essential Plan provides low-cost coverage and valuable benefits, including: 

  • Access to a wide selection of doctors and hospitals
  • Routine preventive care checkups, screenings and immunizations for a $0 copayment
  • No deductible
  • Prescription drug coverage
  • $400 a year toward a fitness facility or individual fitness class reimbursement

Your adult child will likely pay a $0 monthly premium for the Essential Plan if his or her annual household income is at or below 150 percent of the federal poverty level ($17,655 for a household of one; $36,375 for a household of four).

The monthly premium is $20 for each adult enrolled in the Essential Plan if annual household income is between 151 percent and 200 percent of the federal poverty level ($23,540 for a household of one; $48,500 for a household of four).

Your adult child will definitely want to pick up health insurance to avoid the penalty of being without coverage. At tax time next April, they’ll pay about $58 per month in penalty, or 2.5 percent of household income, for each month they are without coverage. And that tax penalty will increase with each month that they remain uninsured. Equally important, is knowing that with coverage, your big kids will be able to afford a doctor visit if necessary.

If you have a child turning 26 this summer, throw a big backyard party, and then have him or her check out the Essential Plan by calling Univera Healthcare at (888) 291-8957, or going online to ChooseUnivera.com/ZeroOption

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