a. Coverage for Adult Dependents - A group health plan or health insurance issuer that offers group or individual insurance coverage and that provides dependent coverage must continue to make such coverage available for an adult child until the child turns 26 years of age. This change is generally effective beginning six months after enactment except that, prior to 2014, this requirement is applicable only for adult children who have no other employer coverage available to them. Employees may qualify for an income tax exclusion for the coverage of adult children under the employer’s group health plan.
b. Comprehensive Health Insurance Coverage – Effective for plan years beginning on or after January 1, 2014, unless considered a grandfathered plan, a health insurance issuer that offers health insurance coverage in the individual or small group market must ensure that such coverage includes the “essential health benefits package.” A group health plan must ensure that any annual cost-sharing (e.g. copayment, deductible, etc.) imposed under the plan does not exceed the limitations provided for in the “essential health benefits package.”
c. Preventive Health Services – Effective for plan years beginning six months after enactment of the PPACA, a group health plan and health insurance issuer in the individual and group markets must provide coverage for certain preventive health services (as defined in the PPACA) with no cost sharing to the participant.
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