Utah Admin. Code R590-259-4 - Eligibility for Dependent Coverage to Age 26; Uniformity of Plan Terms

(1) A health insurer that provides dependent coverage shall make that coverage available until the end of the month the child turns 26 years of age.

(2) With respect to a child who has not turned 26 years of age, an insurer may not define a dependent for purposes of eligibility other than in the terms of a relationship between a child and the insured.

(3) An insurer may not deny or restrict coverage for a child who has not turned 26 years of age based on:

(a) the child's financial dependency;

(b) the child's residency;

(c) the child's student status;

(d) the child's employment status;

(e) the child's eligibility for other coverage, except as provided in Subsection (5); or

(f) any combination thereof.

(4) The dependent coverage may not vary based on age except for a dependent with a disability.

(5) A group grandfathered plan issued before January 1, 2014, may exclude an adult child who has not turned 26 years of age if the adult child is eligible to enroll in an eligible employer-sponsored health benefit plan, as defined in section 5000A(f)(2) of the Internal Revenue Code, other than an eligible employer-sponsored health benefit plan of a parent.

Notes

Utah Admin. Code R590-259-4

Amended by Utah State Bulletin Number 2015-1, effective 12/2/2014 Amended by Utah State Bulletin Number 2023-23, effective 11/21/2023