December 4 , 2006

FirstCarolinaCare Expands Dependent Eligibility

Effective January 1, 2007, FirstCarolinaCare Inc. will expand the definition of “dependent” in its health benefit plans to include children up to 26 years of age regardless of their full-time student status.

Currently, FirstCarolinaCare, and typically other insurers in the state, offers dependent child coverage only up to age 19, unless the child remains a full-time student or is mentally or physically disabled and incapable of self-support.  Under FirstCarolinaCare’s new dependent definition, a child can be covered under his or her parent’s plan up to age 26 regardless of student status. This revision is pending approval by the North Carolina Department of Insurance.

According to statistics presented by the North Carolina Institute of Medicine, young adults account for nearly half of the increase in the uninsured population. Nationally, only half of this segment of the population works for employers who offer coverage and represents almost 20 percent of the total uninsured, or more than 260,000 North Carolinians. According to the Census Bureau, the number of uninsured Americans stood at an all time high of 46.6 million in 2005. That means 15.9 percent of Americans lack health coverage. But lack of insurance affects more than just those without coverage. The cost of the uninsured is passed along to those who are covered through higher insurance premiums and higher costs for medical services.

FirstCarolinaCare, the non-profit health plan subsidiary of FirstHealth of the Carolinas, has been developing ways to help reduce the number of uninsured in its service area since it was formed in 2000. In 2003, it developed FirstPlan, a health benefit plan for small businesses that provides a premium subsidy for eligible employers and lower-wage workers. Now, in an effort to address the staggering rate of growth of the uninsured in the young adult population, FirstCarolinaCare is again being an innovator.

Employers who offer FirstCarolinaCare coverage will be provided the opportunity to opt out of the expanded dependent coverage, and certain conditions will apply to determine eligibility under the expanded definition. Nevertheless, FirstCarolinaCare believes that the innovation will be a popular choice for parents and adult children.

“Statistics show that after age 25, the probability of being uninsured declines gradually with age,” says Ken Lewis, FirstCarolinaCare president. “The decision to extend the age for dependent eligibility to include young adults up to age 26 is a direct reflection of FirstCarolinaCare’s mission to reduce the rate of growth of the uninsured. Broadening coverage ultimately benefits both the business and general community.”

For more information on FirstCarolinaCare’s dependent coverage, or to learn more about the health plans offered through FirstCarolinaCare, call (910) 715-8100 or (800) 574-8556 (toll free).