"Mom, Dad will you buy me health insurance for my birthday?"  Imagine getting that request from your child one of these days. Well guess what; on May 12, 2006 “one of these days” will have arrived. As you all know, that is the day that the newly enacted “Dependant to Age 30” law goes into effect.

We have all been inundated with information about this law. We have been fortunate to get information from DOBI, NJBIA, NJAHU and other concerned organizations. We are well aware of the potential good and bad of this and we are all now preparing for that fateful day when we get the first phone call requesting coverage.

Let’s look at this however, from a different perspective: the uninsured kid’s perspective.

Scenario #1 – Sylvester is a 26 year old fledgling rock star. He lives at home with his folks, is unemployed, but does practice his music every day with his buddies in the family’s garage. On weekends, Sylvester and his band, “Misguided Youth” play local gigs to pick up some cash. His dream is to become a great musician and a celebrity.

Currently, Sylvester is uninsured. Doesn’t Sylvester have the right to get affordable health insurance? What happens if he gets poked in the eye with a drumstick? Sylvester can’t afford to pay for the insurance himself. He has got to spend what little money he has on band equipment, demo tapes, gas, etc. He can’t get a full-time job because he practices all the time so that he can achieve his dream. Why shouldn’t mom or dad have the option to put Sylvester on their plan? They’re not overly happy that they will have to pay the additional premium because Sylvester is virtually broke but at least their baby will be covered in case he falls off a stage in the next 4 years.

POST SCRIPT – The band recently released its first album, “I’m A Primary Beneficiary.”  They are planning a tour this summer. Sylvester has already informed his parents that they will have to pay full price for their tickets.

Scenario #2 – Irv is a 25 year old graduate and post graduate with degrees in archeology and home economics from Texas Christian University. He graduated with honors, did his parents proud and a bright future awaits him. He now lives with 3 other guys in an apartment in Linden, New Jersey. His parents pay his rent and most of his bills but Irv does contribute monetarily via his part-time job at Blockbuster Video. Irv has decided to take a little respite for a year before entering the real world of full-time employment. He figures, after all that schooling and before the grind of a career, he wants to have some fun, “kick back” and relax.

Irv has been uninsured for 2 years. He just never felt the need to be insured. He felt it was too expensive and figured he would become insured when he got a job. His parents worried, what would happen if Irv got hurt or sick? How would they pay for those costly medical expenses?

A friend of Irv’s told him about this new health plan for individuals from Horizon BCBS of NJ called the Basic & Essential “EPO Plus.” The monthly cost would be $177.47. Irv was a healthy young man and this plan provided for more than reasonable coverage. Adding Irv to his dad’s plan at work under the new law, the additional cost would be $248.00 per month. He was saving his folks about$70.00 per month by enrolling in an individual plan. As far as Irv was concerned, when it came to health insurance, he didn’t have to be “dependant to age 30.”

POST SCRIPT – Irv got a job as a researcher on an archeological expedition to Franklin Lakes, NJ where they had discovered artifacts representing what is believed to be ancestors of the original Toll Brothers Builders and Home Developers. On one occasion, Irv fell into a 40 foot abyss and was stuck for about 3 hours. He was finally pulled to safety along with what is believed to be a page from the carpenter’s union very first collective bargaining agreement. Irv left archeology quickly and, using his degree in home economics is now a production assistant on Rachel Ray’s T.V. show on the Food Channel.

Scenario #3 – Babette is 29 years old, lives in Pluckemin, NJ and last week she started her new job as a translator at the United Nations. Before that, she lived in Kansas where she had hoped to gain employment as a ski instructor but the job market proved scarce. In Kansas, Babette was not covered under any type of health insurance. She is anxious to get enrolled in the health insurance plan at work. Problem is, the health plan has a 3 month waiting period for new employees. Babette’s dad, Jim Bob, suggests that she enroll under his plan at work as an overage dependant till her coverage at work begins. Jim Bob’s PPO plan is great, $10 co-pay, 500 deductible, 80/20 co-insurance and a $15 prescription plan. The premium for Babette will be $553.00 per month. Neither Babette nor her father can afford that extra premium.

Jim Bob asks his employer to contribute to dependant coverage like he does for the other employees but the employer explains that, under this new law, he does not have to contribute premium for overage dependants.

Babette makes the unfortunate decision to remain uninsured for the next three months. She figures, if anything really bad happens, she can file claims under New Jersey’s “Charity Care” program.

POST SCRIPT – Babette survived the 3 months without incident and is now covered at work. Jim Bob is doing fine also.

So there you have it. Three separate scenarios of uninsured young adults, each with different outcomes. The dependant to Age 30 law will obviously benefit some people but not necessarily ALL people. It could be construed as a “quick fix” to the uninsured problem in New Jersey but not necessarily the only one. You and your clients need to weigh all options carefully. Coverage and cost are, of course of paramount concern. They are at least 4 carriers in New Jersey that have very reasonably priced individual plans. Those plans may also provide a welcome answer to the uninsured overage dependant.

Return  View Blog Archive