I have a question I cant seem to get a straight answer to. Our adult child is covered on our insurance through my husbands work. The adult child is racking up medical bills which are coming to us (we don’t have contact with her). When we notified our insurer, Kaiser that we will not pay for these bills, we were told as long as she’s on our insurance we are responsible; if we do not pay the account goes to collections.

My husbands employer refuses to drop her stating unless we can provide evidence she already has other coverage there is nothing they can do under the Affordable Care Act. I read the Act, and I can only determine they must offer it up to age 26. Can it be that we are not only forced to cover her but also pay her bills?! There is nothing stopping her from acquiring coverage on her own through a marketplace.


Answer

Your employer has to offer coverage, but you do not have to accept coverage. So your employer should allow you to refuse coverage for a dependent or drop a dependent from the plan.

With that said, there are specific rules that apply here, and this could cause a problem. One problem is this: Once a dependent is on your plan, you can only remove them during open enrollment or by them getting other coverage and thus qualifying for a special disenrollment period.

Meaning: You can reject dependent coverage in the first place, but once they are on your employer plan you can't just drop them for no reason at any point.

That being said, some of these rules are complex. Most of the Department of Labor stuff we can find on this focuses on keeping dependents on plans, same with the law itself. We have seen official documents that discuss, as your employer says, dropping dependents from a plan if they have other coverage options. But we are failing to find an official document that says an employer is in compliance if the employee drops a dependent under 26 without other them having other coverage options.

We suggest the next step is calling the insurer themselves and discussing the fact that you want to drop her from the plan. That gives you a third party who can help to clarify specifics. Here is some good information on employer responsibilities from a third party, you'll notice again that there is nothing forcing the employee to accept coverage (but there are rules from dropping dependents from coverage).

The above being said, keep in mind you can find yourself ending up owing the fee for your dependent if you claim them on your taxes.

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Johnny on

Can I drop a child of my insurance at the age of 18

ObamaCareFacts.com on

If you file for a dependent then you have to provide them coverage (or else-wise comply with the individual mandate). If they file taxes on their own and you don’t claim them then you don’t. So yes, at 18 a child can file on their own and get their own coverage and thus you don’t have to provide coverage for them.

susan on

This answer fails to address the fact that to be compliant with IRS regulations and employer has to have specific regulations about when changes can be made to insurance coverage. The vast majority of employers only allowed changes to coverage during an annual open enrollment period or within 30 days of a qualifying event, such is getting other coverage, losing coverage,marriage, divorce etc.

Jeri on

Our daughter is 23 years old,has a baby and lives with her boyfriend. Can we drop her off our insurance without being penalized even if she doesn’t have her own insurance policy?

Jenny on

If you elected coverage for this dependent and then changed your mind, you will need to wait for a qualifying event. Your employer may not be allowing you to drop your dependent mid-year during their plan year. You will either need to wait for a qualifying event (reaches age 26, gets coverage through another plan other than a private plan, etc). If there’s not a qualifying event, you will need to wait for open enrollment. There are not enough details provided to determine if you are “in the right” or your employer is.

erin.georgen@gmail.com Erin on

Your employer can not force you (or your dependents) to take or keep the employer coverage they offer. You will need to ensure your dependent has other coverage qualifying as minimal essential coverage though, and may find it difficult to sign him up for another insurance outside of qualifying for open enrollment. If you have any additional issues with your employer you may try calling the office of your state’s Insurance Commissioner and/or Attorney General.

Remi on

My child is 3 years old and I cannot afford to keep her on my employer plan. I applied for FloridaKid Care for her and was denied because she is currently enrolled in a insurance plan. Can I keep my coverage but remove her and than reapply for FloridaKid Care? Or would she not qualify either way because my employer offers dependent coverage??

Erin on

Children qualifying for CHIP programs depends on the families income level and it varies state to state. According to the chart in this Medicaid page, Florida offers some form of CHIP coverage to children age 1-5 if their families make under 140% of the Federal Poverty Level. FloridaKid Care and ask them directly what the income eligibility criteria is and what coverage your son would be eligible for (Is that low or no cost coverage?). If your income is eligible, you can enroll your son. If not, you will don’t have to use your employers dependent coverage options, but you will likely not be eligible to receive cost assistance for marketplace plans. You can always shop outside the Marketplace for health insurance though and sometimes (occasionally you can see in these comment threads) report finding less expensive minimal essential coverage by simply shopping around.

David Shea on

My wife works for a health care provider that is also a health insurance company.
Although my employer offers health insurance coverage, i have waived that and I am covered my wife’s plan because it affords better benefits. Her employer deducts the premium for our coverage AND an additional amount since I have employer coverage available but opt to be covered under her plan. Is that allowed under the ACA?

Megan Boyle on

Hi! If I enroll my children in the plan that my employer offers, can I still apply for CHIP, and if approved for CHIP then drop my children from my employer’s plan?

erin.georgen@gmail.com Erin on

Yes, you can still apply for CHIP to cover your children and if approved, they will not need the employer coverage for you to have met the requirements to avoid the fee.

Maria Quintana on

If I remove my child from my health insurance will he be able to use it?

Erin on

No your child won’t be able to use insurance if you drop him from coverage.

kim allen on

So if you dropped children under 26 not living with you and you don;t file taxes for them during your insurers open enrollment then they should have done as you asked. my boyfriends employer said under Massachusetts law he had to keep family coverage and they added them back on.

Is there a law that says you have to keep dependents under 26 in this case ages 23 and 24 on your insurance if they don’t live with you and you don’t claim them as dependents on your taxes.

Bob on

You can only drop your child if there is a qualifying event(marriage, etc.) unless they have other insurance. But, you CAN chose to not enroll them if you have a yearly signup.

That being said, my bigger concern with the question above is that you were told that you are responsible. If your child is a legal adult(over 18) you are not responsible for their bills. Call the doctor/hospital and ask for all of the records related to a charge and you will be told that because of HIPPA you cannot have that information. Adults are adults and responsible for their actions.

Mary Ortiz on

My husband pays 210.00 biweekly for insurance for his 2 daughters. One lives full time with us one lies full time with her mom…we have 2 small children they qualify for chip because of our low income.. Can he cancel thy insurance for thy daughter that lives with us. So I can add her to chip?

JD Kimbrell on

I have a court order to provide health insurance for a child who is not mine, but I was married to her mother. The Court order says that two conditions have to be met. 1. The child graduates from High School, and 2. the child turns 18 years. Both of those conditions have been met. Can I drop the child from my insurance? My Employer seems to think I cannot drop her until October, at open enrollment. Please help with this answer.

ObamaCareFacts.com on

There are specific rules for this sort of thing (they aren’t the easiest thing to come by either). That said, their advice is I believe correct. One way around this is if they get their own employer-based coverage (that opens a special disenrollment window for example).

Bottom line here is this: If a dependent is on an employer plan, you can’t take them off until open enrollment unless they qualify for other coverage that would trigger a disenrollment period. Court agreements do not override this as far as my research can tell.

I always suggest calling the insurer for more direction on these sorts of things. There isn’t a handy guide to every aspect of this, but the insurer should be able to clue you in on specifics.

Brian on

Can I drop my child from my insurance at 18 even of she is still in highschool?

ObamaCareFacts.com on

Keeping in mind we only offer general advice (and don’t offer legal advice here). This is the gist:

Parents have a right to continue to insure their children on their health plans until age 26. But this is a right — not an obligation.

It doesn’t matter if they are in school or not as far as I know. I don’t think there is any legal requirement to provide healthcare for your children… unless we are talking about child support and divorce agreements and such.

That said, if you file taxes for your child, then you will owe the fee for them too (and your family size will reflect them being a dependent).

So there are some things to think about.

Regena Allen on

I myself is trying to drop my estranged husband from my ins. Through my job and they refuse to unless I have the final divorce papers to show them. He refuses to sign divorce papers so it will never be final! I don’t think it’s fair for me to pay his ins. Especially since I can’t afford to. What can I do?

ObamaCareFacts.com on

That doesn’t seem fair, I don’t however know the answer in this situation. I would consider looking over DOL guidelines or getting advice from a lawyer in that position. It is somewhat a complex matter.

cathy on

my husband has been required to pay child support and cover his child with healthcare until she turns 18 and graduates high school she will graduate in May will he be able to drop her from coverage at that time

ObamaCareFacts.com on

In general coverage has to be provided until the end of the calendar year unless the person is switching plans.

https://obamacarefacts.com/questions/can-i-drop-my-dependent-from-employer-coverage/

Ang on

I have the same problem, the kid is running the streets & her medical bills are stacking & she does Not live with me anymore & the insurance company will Not allow me to remove her, I guess this is some ACA law,
Have You neen able to temove Your kid yet??

Sharon on

I am not a lawyer, but I do not believe something just because some huge corporation says it is so. I have stood my ground based on laws and won a few times against the large corporations, probably because I was more of a pain than they wanted to endure. I do know that I assume responsibility for my daughter’s medical expenses when I sign for that on the medical forms at her doctor’s office. It only seems logical that paying for your child’s health insurance is one issue, paying for their medical bills from a doctor’s office is a completely separate issue. I hand delivered letters to my daughter’s doctors’ offices stating that as of this date I am no longer responsible for and will not pay her bills from this office. The billing department fought back saying that I signed that I would pay. I stated that yes I initially signed to pay but I am now stating that from this date forward I will not pay, so this letter invalidates any previous paperwork. I had to go up the food chain until I found someone knowledgeable, but they eventually accepted my letter. Corporations do their best to squash the little guy. Don’t believe anything they say. Google the law, call your state librarian, who can help you with the laws, but don’t believe what a corporation tells you.

ObamaCareFacts.com on

I agree 100%. It is always good to communicate with your employer (or an insurer), especially since rules can be complex, but that doesn’t mean you can’t question their logic and appeal. If something doesn’t seem right, take the time to get an answer that is satisfactory and fight the results if you need to.