The Affordable Care Act and Dependent Coverage

The ACA does not require that coverage offered to dependent children be "affordable" or subsidized at the same level as employee coverage.

Therefore, an employer can choose not to pay for any of the dependent coverage. However you’ll certainly want to weigh this option with offering a competitive benefits package in order to attract and retain good talent.

Dependent Health Care Coverage

So what is a “dependent?” According to the Department of Labor and the ACA, a person has to be one of the following:

• Biological children (sons, daughters)
• Stepchildren
• Adopted children (including children placed for adoption)
• Foster children who are placed with the employee by an authorized placement agency or by judgment, decree, or other order of any court of competent jurisdiction.

Coverage must be offered to anyone in the above categories, up to age 26. A dependent can join or remain on a parent's plan even if they are:

• Married
• Not living with their parents
• Attending school
• Not financially dependent on their parents
• Eligible to enroll in their employer’s plan

Bottom line: Employers will need to calculate whether they are small or large according to the Affordable Care Act. See our Company Size Calculator for help with this important calculation. They will then need to decide whether to offer coverage to their full-time employees and dependent children — and how much, if any, to subsidize dependent coverage.