Many PEF parents take advantage of Health Reform option to cover young-adult children


By DEBORAH STAYMAN Thanks to the PS&T contract and


state law, PEF members already enjoyed some of the benefits of national health reform before it began to take effect. One feature of the national reform,


however, is a big hit with members because it allows them to protect their children who have recently left the family nest.


January 1. Ramsden’s 23-year-old daughter had taken a break from college and was uninsured. During that time she got sick and saw a doctor. Ramsden had to pay that bill entirely out of her own pocket. It was a shock. “That was so expensive,” Ramsden


said. “I’m glad she has insurance now.”


Just in time At the age of 24, Christopher Preall


discovered he had a life-threatening illness. His father, PEF Region 7 member Richard Preall, made sure to continue Chris’ student enrollment in the family’s state health plan until he turned 25. Christopher


KAREN AND LEIGH ENGEL


Such a relief Region 8 member Karen Engel, for


instance, said she is very glad to be able to cover her 23-year old daughter under her state-employee health plan again. Her daughter finished college in May 2010, and after her student eligibility ended, she was able to buy affordable insurance through Healthy NY.


The state subsidizes Healthy NY,


and it is only available to state residents. However, in January 2011, Karen’s daughter moved to Florida to begin an internship that pays a small stipend but does not provide health insurance. Fortunately for Engel and her


daughter, the new national health care reform legislation extends coverage to young adult dependents to age 26, even if they are a thousand miles away from their parent. So, Karen was able to re-enroll her daughter as a dependent in her NYS plan.


Uncovered = expensive Region 10 member


Karlene Ramsden took advantage of the reform to re-enroll her 23-year-old and 24-year-old daughters on her family plan effective


www.pef.org


Preall was in the intensive- care unit at a local hospital on his 25th birthday. So, his father paid the full premiums, as required to extend his son’s health coverage under COBRA. That’s the federal Consolidated Omnibus Budget Reconciliation Act program that permits temporary continuation of benefits. Thanks to the national health care


HMO through the New York State Health Insurance Program (NYSHIP), may enroll their children up to age 26 as dependents on their health insurance. There is no additional cost, unless you currently have individual coverage and will need to change to family coverage. The extension of coverage applies


only to medical benefits, and does not apply to dental or vision benefits. (Note: If the young adult is a full-time student younger than 25 or disabled, he/she can continue to receive dental and vision benefits at no cost, upon verification of eligibility.) Contrary to earlier reports, a young


adult can be eligible for, or enrolled in, his or her own employer- sponsored plan and still enroll as a dependent in a NYSHIP family plan. Although


MARYBETH, CHRISTOPHER AND RICH PREALL


the new law extends coverage to married


children, it does not apply to their spouse or children. The dependent coverage extension


reform extending benefits for dependents to age 26, Richard Preall was able to re-enroll Chris in his family’s health plan effective January 1. Not only was it timely, it was affordable. “Because Chris had that coverage, he got to the doctor in time,” Preall said. “Had my son not been insured, he might have hesitated, thinking it was something minor.” Fortunately, the


younger Preall is recovering well and has resumed his post-graduate studies at SUNY Geneseo.


KARLENE RAMSDEN in the Empire Plan or an


How does it work? PEF members enrolled


The Communicator March 2011—Page 11


under national health reform is different from NYSHIP’s Young Adult Option, which requires a young adult to enroll in a separate individual plan and pay the full (employee and employer contributions) premium. The Young Adult Option, which will continue to be available, can cover an eligible dependent from age 26 to 30. It is for medical benefits only, and does not include dental or vision benefits. Young adult dependents may


continue to be added to a PEF member’s health plan on a current basis. See your agency’s health benefits administrator in the personnel office for assistance.


Health Notes


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