Wisconsin Emergency Rule Extends Health Coverage to Young Adults

November 2, 2009 (PLANSPONSOR.com) - The Wisconsin Office of the Commissioner of Insurance (OCI) has issued an emergency rule implementing a new law that extends health insurance coverage for residents up to 27 years old.

The emergency rule, announced by Wisconsin Governor Jim Doyle last Thursday, clarifies a new law, passed in June 2009, requiring health insurance policies to cover eligible young adults up to age 27.   The law applies to individual health and group health benefit plans and a self-insured plan of the state, or a county, city, village, town or school district, including limited scope plans, such as vision and dental plans.

According to a statement from the Governor’s Office, the rule clarifies:

  • The calculation for eligibility based on premium costs
  • Eligibility for military personnel
  • Eligibility for students
  • Eligibility for non-resident young adults with resident parents
  • Eligibility for young adults previously dropped from coverage because of their age

To be eligible for this coverage young adults must be over 17 but less than 27 years of age; not married; and either not eligible for health coverage through the young adult’s employer or whose premium contribution for employer coverage is greater than the additional premium amount the parent is required to pay to add the young adult to the parent’s health plan.  

Additional eligibility rules apply to young adults who are called to federal active duty in the National Guard or reserves while a full-time student, according to the announcement.   The statute goes into effect for health insurance policies issued or renewed beginning on January 1, 2010.

The emergency rule can be viewed at OCI’s Web site at http://oci.wi.gov/rules/0334em09.pdf