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8-11-2010
Management Benefits Fund (MBF) Coverage for Young Adult Dependents

Management Benefits Fund (MBF) Coverage for Young Adult Dependents


This past June all members of the Management Benefits Fund (MBF) received the attached letter from the MBF which offers Direct Pay Coverage Continuation (DPCC) for eligible dependent children through age 29 (Young Adult Dependent).

Under this program the MBF offers coverage for the Superimposed Major Medical Plan (SMMP), Dental and Vision Care Programs, at a designated premium, depending upon the option selected i.e. (1) SMMP only (2) Dental & Vision Care only or SMMP, Dental & Vision Care Programs.

If members do not opt for MBF enrollment for previously terminated dependents by August 31, 2010, these dependents will lose their right to be added back to the member’s coverage later on, and will not be eligible for MBF paid coverage for those who have not reached their 26th birthday.

The purpose of this memorandum is to highlight and provide additional information so that affected members can make more informed decisions.

I. Even if dependents were previously terminated prior to MBF adopting the DPCC law effective July 1, 2010 they can be enrolled, as long as they meet the eligibility criteria and the MBF member is active in MBF. However, members must exercise this option by completing the form on the reverse side of the letter received and return it to the MBF no later than August 31, 2010. Coverage will begin on September 1, 2010.

For prospective dependents who will be terminated because they are attaining the age of 19, or 23 if a full time student, members must submit the DPCC Enrollment Form within 60 days following the termination date.

II. Monthly premium bills will be received from Healthplex, and will vary depending upon the coverage selected.

III. Effective no later than July 1, 2011 in conjunction with the Health Care Reform Act, the MBF will absorb the premium cost for all dependents, provided they have enrolled within the 60 day periods cited above, and have not yet reached their 26th birthday (after which they will again be billed by Healthplex).


IV. There is also a Young Adult Option for eligible dependents to continue health benefits coverage through age 29. This information is available through our web link (www.nycmea.org) to the New York City Office of Labor Relations Health Benefits Program. The eligibility criteria are similar, with one significant difference - the dependent cannot be insured by or be eligible for comprehensive (medical and hospital) health insurance through his or her own employer. There is an additional monthly premium billed by the health plan, the amount varying based upon the member’s health plan and option selected.

Effective July 1, 2011 premiums for enrolled Young Adult Dependents who have not yet reached the age of 26 will not be separately billed; rather the plan is to include them within the member’s coverage. What this means is that a member having single health coverage will pay for the addition of a dependent, while members with family coverage would not be assessed any additional premium. Because there is also an initial 12 month open enrollment period which commenced on July 1, 2010 in addition to a 60 day enrollment requirement, there is a greatly reduced urgency for members to make an immediate decision regarding YAD coverage.

V. However, if members do not opt for MBF enrollment for previously terminated dependents by August 31, 2010, these dependents will lose their right to be added later on; subsequently they will not be eligible for MBF paid coverage for those who have not reached their 26th birthday.



  
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