The percentage of health plan members who take advantage of new young adult coverage access mandates may be small.
Sean Dilweg, the Wisconsin insurance commissioner, looks at the effects of a 2009 Wisconsin state young adult coverage access mandate in an impact analysis prepared for state lawmakers.
The Wisconsin law requires a plan that provides dependent coverage to define the term “dependent” to include any unmarried child who is under age 27 and “is not eligible for coverage through his or her employer at a premium less than or equal to that of the dependent coverage under the parent’s policy,” Dilweg says.
If the child is a full-time student whose education was interrupted when he or she was under 27 by service in the National Guard or reserves, the insurer must offer dependent coverage for as along as the child is a full-time student, regardless of age.
Insurers can use the same rules for determining the cost of coverage that they would use for dependents under age 18.
In Wisconsin, fully insured products cover about 1.7 million residents, and the state has about 136,000 uninsured residents ages 18 to 26.
When officials conducted an informal survey of insurers that serve a total of about 63% of the Wisconsin group plan market and 61% of the state’s individual market, they found that about 1.7% of the large group plan members made use of the young adult access mandate.
The mandate use rate has been 1.4% for members of small group plans and 0.8% for holders of individual coverage.