Extending health coverage to employees’ grandchildren

Q         Is there any law requiring an employers' group health plan to extend coverage to an employee's covered child's child (the employee’s grandchild)?

A   Under current law, businesses that employ 50 or more employees are required to offer them health insurance. Additionally, plans that offer dependent child coverage must make it available until the dependent child is 26 years old. Therefore, when an employer’s health plan extends coverage to children, employees can keep their children on their health insurance policy until they turn 26, even if the child is married, not living with his or her parents, is financially independent, or is eligible to enroll in his or her own employer’s plan. The dependent child’s prenatal care is included in the coverage.

Current law does not, however, explicitly extend coverage to an employee’s covered child's child. As such, you aren’t generally required to provide your employees with a health plan that covers their grandchildren. Nevertheless, they can still inquire about whether their health plan has an option to cover grandchildren.

Additionally, even if an employee’s health plan doesn’t explicitly extend coverage to grandchildren, employees can add a grandchild to their health insurance plan if they have legal guardianship and the grandchild resides with them. Finally, an employee’s grandchild may be eligible for Medicaid, the federal-state program for low-income people, or the Children’s Health Insurance Program (CHIP), which has slightly higher income limits.