Dependent Aging Out: What Happens When Your Child Turns 26?

The Affordable Care Act (ACA) allows young adults to remain on a parent's health plan until they turn 26 years old. While this is a huge benefit, once that 26th birthday hits, coverage will terminate! This change is known as Loss of Health Coverage, and it's recognized as a Qualifying Life Event (QLE).

This guide outlines the process, your responsibilities, and how GoCo helps you manage this transition smoothly.

What is the Employee's Responsibility? (Heads Up! 🔔)

It is the employee's responsibility to know when their dependent is aging out and to initiate the removal process in GoCo. GoCo does not automatically terminate or notify an employee about an upcoming dependent birthday.

When Does Coverage End?

Coverage typically ends on the last day of the month in which the dependent turns 26, though this can vary slightly by your specific health plan.

The Employee Action in GoCo:

The loss of dependent coverage allows the employee to enroll in other coverage options through the Marketplace or elect COBRA. To update their current employer-sponsored benefits, the employee must log the QLE in GoCo.

1. Access Your Benefits Module: Log in to GoCo and navigate to your My Profile page. Click the "Manage" on the Benefits card.

2. Start the Change: In the Benefits Module, click the blue "Make Changes" button.

3. Select the Change Type: Choose "Remove a dependent" from the options.

   • ⚠️ IMPORTANT: You must have a qualifying life event for carriers to remove a dependent from any of your current plans. Select your reason for removing the dependent, choose the last day of coverage, and upload a supporting document

4. Select the Reason & Upload Document: When prompted select the reason for change, last day of coverage, and upload a supporting document.

5. The next page will show you all the lines of coverage that the dependent is currently enrolled in. Check off the lines of coverage that should be removed.

   Note: If the checkbox is checked, that line of coverage will be removed. Click Finish.

   

   6. In some instances, your terminated dependents might be eligible for COBRA or State Continuation. In those instances, we'll prompt you to verify your dependent's address so we can send the proper documentation.
   
   7. You're done! We will submit the change request to the insurance carriers. 

What Happens to the Dependent's Information in GoCo?

Is the Change Automatically Synced?

No, the dependent's removal is not fully automatic or immediately synced to the carrier. The process involves a necessary review step:

1. QLE Submission: When the employee hits "Finish Enrollment," the QLE is submitted.

2. Admin Approval : Depending on your organization's setup, the qualifying life event may need to be approved by your HR administrator.

3. Carrier Approval: Once the Admin approves (or if no approval is needed), the change is submitted to the insurance carrier for final processing.

Where Can the HR Admin See This Update?

HR Admins or Brokers can monitor this change within the system:

1. Check for Notifications: Admins will often receive a notification in their GoCo inbox that a new QLE is awaiting review.

2. Review the Pending QLE: Navigate to the Employees page > Benefits > Life Events. The dependent's removal will appear here as a Pending QLE.

3. Review and Approve: The admin must review the information and, if everything is accurate, approve the QLE to push the change to the carrier.

Post-QLE: Dependent Coverage Options and COBRA

Losing coverage due to turning 26 is a significant event, and your dependent is entitled to specific options:

• COBRA or State Continuation: In many instances, the terminated dependent might be eligible to continue coverage temporarily under COBRA or State Continuation. GoCo will prompt the employee to verify the dependent's address during the submission process so the proper COBRA documentation can be sent.

• Special Enrollment Period (SEP): The loss of employer-sponsored coverage triggers a Special Enrollment Period, allowing the young adult to enroll in an individual plan through a government Health Insurance Marketplace.

• How long does the employee have to make the change? The employee typically has 30 days from the date of the Qualifying Life Event (the 26th birthday) to make the coverage change in GoCo to ensure the carrier approves the removal/change request.