The Affordable Care Act

[bobabode]

Originally Posted by whell

Trust me, that's how it works but you can bloviate your bull shit call if you want.

Certainly in the large group market historically, and now standardized in the small group marekt, most carriers offer coverage (or most self insured plans) based on either three or four tiers, each with their own premium:

Employee Only
Employee Spouse
Employee Child(ren)
Family

Some carriers use three tiers, some four tiers, but generally the tiers are some combination of those shown above. The premiums for each of those tiers is pre-determined each plan year. There is no additional charge to a plan participant on any of the family tiers (bolded) if a participant chooses to add dependent up to age 26.

To put it another way, let's say two employees work for the same company. Both have families. The employer offers medical coverage as a large group employer (more than 50 employees), the monthly premium for family coverage is $1000, and the employer splits the cost of the premium 50/50 with employees.

Employee A elects medical insurance under the employer's group policy. He has a wife and 3 kids, all the kids are under age 18. His monthly share of the premium is $500, or 1/2 of the full $1000 monthly premium.

Employee B has a five and 4 kids, all under age 18. His monthly share of the premium is also $500, or 1/2 of the full $1000 monthly premium.

Now, lets say employee B has 4 kids, but one of them is age 22. What would his premium be? His monthly share of the premium is also $500, or 1/2 of the full $1000 monthly premium.

Things change a bit in the small group and individual markets. But as you folks like to often insist on this forum, that's not where most folks work. So, employees working in companies with 50 or more employees would not have to pay additional premium for adding either additional minor dependents (under age 19), or additional adult dependents (up to age 26).

Do those waffles come with blueberry syrup?