Health Care Reform, in the form of the Patient Protection and Affordable Care Act, has brought about many changes for employers and their health plans. Required changes will be effective beginning on the first day of the first plan year starting on or after September 23, 2010. For the North Coast Schools’ Medical Insurance Group, our first plan renewal after this date is July 1, 2011. On this date, many changes, such as eliminating lifetime maximum limits on essential benefits or eliminating pre-existing condition exclusions for children under age 19, will become effective for your plan. However, the largest change for our members will be the ability to add eligible dependents to their plan through the end of their twenty-fifth year, also stated as to age twenty-six. The law does not require your eligible dependent to be enrolled in school full-time or to qualify as your IRS dependent.

Your employing school district, as a member of the North Coast Schools’ Medical Insurance Group, will be holding a special enrollment period in the month of June to add qualifying dependents to your plan. The legislation that was passed extended coverage only to those eligible dependents who did not have access to health coverage through their employer, even if it was at their own cost. This meant that your eligible dependent who was eligible to participate in their own employer-sponsored health plan, even if it meant contributing a large portion of the premium themselves, would not be eligible to be added to your plan. At the May 18, 2011 Board meeting of the North Coast Schools’ Medical Insurance Group, the decision was made by the Board of Directors to voluntarily waive “grandfather status” for all plans administered by the group for this particular issue. By voluntarily waiving this provision, the North Coast Schools’ Medical Insurance Group will now allow all eligible dependents to enroll on their parent’s plan through the end of their twenty-fifth year, also stated as to age twenty-six.

The process for enrolling your eligible dependent will be the same as it currently is for all eligible dependents. You must provide a copy of your child’s official birth certificate and complete an enrollment form with your school district. The district then forwards this information to the North Coast Schools’ Medical Insurance Group to be submitted to our coverage partners.

Enrollment forms and official birth certificates must be submitted directly to your employer, not to the North Coast Schools’ Medical Insurance Group. The timeline for this Special Enrollment Period will be June 1, 2011 through June 30, 2011. All properly completed enrollment forms submitted to the member district by June 30, 2011 will be enrolled with an effective date of July 1, 2011. Incomplete submissions will not be accepted and enrolled.

Please note that this Special Enrollment Period is only for those eligible dependents over age eighteen who qualify for coverage as outlined in the Patient Protection and Affordable Care Act. This Special Enrollment Period is not the same as the Annual Open Enrollment Period and therefore, does not extend to eligible spouses, domestic partners or other dependents who were not added during their initial eligibility period.

If you would like more information on how to enroll your eligible dependent, please contact the benefits coordinator at your school district for an enrollment form. For any other assistance, you can contact the North Coast Schools’ Medical Insurance Group at (707) 445-7126.