Views

Insurer rep offers opinion on dependent eligibility extension

Last week, I shared some of the supportive e-mails I’ve received about my less-than-supportive position on the dependent eligibility extension provided under health care reform.

To be fair, not all the e-mails I’ve receive were supportive, though. Like one I received recently from an account manager at a very (very) large health insurer that I’m quite positive many of you are renewing with as I type this.

The account manager, who shall remain nameless, offered this take on letting kids (air quotes) stay on their parents’ health plan until age 26:

If I had my way, parents would be allowed to keep unmarried kids on their plans to age 30.  The overall benefits of this far outweigh the risks/hassle:
 
* Covering someone under a group plan is always less expensive (for everyone) than covering them under an individual policy.
* If we as a society think that insurance coverage should be mandated (like car insurance is) — and I do — then covering this age group would help a lot of families.
* Medical claims for this age group are extremely low relative to other age groups. Yes, some employer somewhere may pick up a 26-year-old who is sick, but for the most part, people in this age group are very healthy.
* The economy and job market is terrible right now.  There are not many jobs out there for kids coming out of college, and many who get jobs have no insurance benefits/coverage.  Allowing kids to stay on their parents plan helps both the family and the kid from an economic standpoint.

There are many provisions of the so-called "reform" legislation that will not solve any problems at all (especially cost drivers).  But this is one good provision.

To say I grumbled after reading this e-mail is an understatement. But I gave John Doe Health Insurance Rep my best diplomatic reply:

Thank you for taking the time to write in. It’s interesting to hear an alternative perspective. However, just to play devil’s advocate: Would you feel any differently if you were an employer, who stood to lose time and money by covering adult dependents, as opposed to your current role with a health insurer, which stands to profit from the provision? Not being confrontational, just asking.
 
To my surprise, he wrote back:

You are not being confrontational at all. We are all in the same boat.
 
First, as an insurer, we do not stand to profit anything by this stuff at all.  The cost to administer/communicate it far outweighs any benefits from our perspective. We do not increase rates because we now have to cover 25- and 26-year-olds.  …  The reform legislation does absolutely nothing to address underlying costs of medical care.  And until we do that, costs/rates/etc. will continue to climb. 

Back to being an employer:  If I had employees who had kids who were 25 or 26, and those kids could not find work so they could not possibly even think about buying insurance coverage, I would be happy to cover those kids under my group medical plan. I am doing my employees and their kids a favor, which I am sure they would not soon forget.  It is good for employee relations. Otherwise, my employee has to spend $150 per month of his own money to buy insurance for his/her 25-year-old daughter who cannot find work, has no income, but surely needs coverage just in case — so he is going to be coming to me asking for a raise to cover that $150 cost.

So, what say you? Does hearing this rep’s perspective change your opinion on the dependent eligibility extension? Or do his thoughts not amount to a hill of beans? Fire away in the comments.

For reprint and licensing requests for this article, click here.
MORE FROM EMPLOYEE BENEFIT NEWS