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The Statute is below. My question is if a parent has a family health insurance policy through work, and the son is 21 but not a full time student, and he is living at home and fully dependent on parents, (as he doesn’t work,) would the son be qualified as a covered dependent for healthcare due to this statute? Prior to this provision the coverage would of ended when turning 21, because he would not be a full time student. He turned 21 the same month this provision became in effect. I think yes, the parent can still claim as a dependent and cover under group insurance because it reads “OR” (the child is a full-time or part-time student). So although he is not a full time student he does meet the first part “The child is living in the household of the policyholder or certificateholder” and fully part “1a”. Please advise if you think the provision means as I have thought, the son can be covered.

The 2008 Florida Statutes

Title XXXVII
INSURANCE Chapter 627
INSURANCE RATES AND CONTRACTS

1627.6562 Dependent coverage.–

(1) If an insurer offers coverage under a group, blanket, or franchise health insurance policy that insures dependent children of the policyholder or certificateholder, the policy must insure a dependent child of the policyholder or certificateholder at least until the end of the calendar year in which the child reaches the age of 25, if the child meets all of the following:

(a) The child is dependent upon the policyholder or certificateholder for support.

(b) The child is living in the household of the policyholder or certificateholder, or the child is a full-time or part-time student.

(2) A policy that is subject to the requirements of subsection (1) must also offer the policyholder or certificateholder the option to insure a child of the policyholder or certificateholder at least until the end of the calendar year in which the child reaches the age of 30, if the child:

(a) Is unmarried and does not have a dependent of his or her own;

(b) Is a resident of this state or a full-time or part-time student; and

(c) Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group, blanket, or franchise health insurance policy or individual health benefits plan, or is not entitled to benefits under Title XVIII of the Social Security Act.

(3) If, pursuant to subsection (2), a child is provided coverage under the parent’s policy after the end of the calendar year in which the child reaches age 25 and coverage for the child is subsequently terminated, the child is not eligible to be covered under the parent’s policy unless the child was continuously covered by other creditable coverage without a gap in coverage of more than 63 days. For the purposes of this subsection, the term “creditable coverage” has the same meaning as provided in s. 627.6561(5).

(4) This section does not:

(a) Affect or preempt an insurer’s right to medically underwrite or charge the appropriate premium;

(b) Require coverage for services provided to a dependent before October 1, 2008;

(c) Require an employer to pay all or part of the cost of coverage provided for a dependent under this section; or

(d) Prohibit an insurer or health maintenance organization from increasing the limiting age for dependent coverage to age 30 in policies or contracts issued or renewed prior to the effective date of this act.

(5)(a) Until April 1, 2009, the parent of a child who qualifies for coverage under subsection (2) but whose coverage as a dependent child under the parent’s plan terminated under the terms of the plan before October 1, 2008, may make a written election to reinstate coverage, without proof of insurability, under that plan as a dependent child pursuant to this section.

(b) The covered person’s plan may require the payment of a premium by the covered person or dependent child, as appropriate, subject to the approval of the Office of Insurance Regulation, for any period of coverage relating to a dependent’s written election for coverage pursuant to paragraph (a).

(c) Notice regarding the reinstatement of coverage for a dependent child as provided under this subsection must be provided to a covered person in the certificate of coverage prepared for covered persons by the insurer or by the covered person’s employer. Such notice may be given through the group policyholder.

(6) This section does not apply to accident only, specified disease, disability income, Medicare supplement, or long-term care insurance policies.

History.–s. 131, ch. 92-33; s. 9, ch. 2008-32.

1Note.–Section 9, ch. 2008-32, provides that s. 627.6562 is amended “[e]ffective [May 21, 2008,] and applicable to policies issued or renewed on or after October 1, 2008.”