business

Patti Rochek was bracing for her college-student daughter to be kicked off her employer's health insurance after the 20-year-old decided to take a semester off this year.

But thanks to the federal health care overhaul, that won't happen. Her daughter, Catlin Arndt, can now stay on Rochek's company plan up to age 26, even if she's not a full-time student. "I was just thrilled and relieved," said Rochek, a sales coordinator with Graco in North Canton, Ohio.

That provision and an array of other consumer protections are set to kick in this month. The White House is hoping that the measures will help quell critics of the health care law, turning it from a promise and an abstraction in people's minds to a program with real-life benefits.

Many of the looming fixes address items that have infuriated consumers about their health insurance over the years. In addition to allowing all kids to stay on their parents' insurance until age 26, the new provisions include preventing insurers from denying coverage to sick kids, gradually closing the doughnut hole that leaves a gap in seniors' drug coverage, and doing away with caps on annual and lifetime medical costs.

"Americans want to know how health insurance reform affects their communities," Health and Human Services Secretary Kathleen Sebelius said last week. "We have been working closely with states on implementation -- and the immediate benefits of this historic legislation are beginning to take effect."

Americans in general remain deeply divided over the health law. Some 29 percent of Americans think that they and their family will be better off under the law versus 30 percent who say they expect to be worse off, according to an August poll by the Kaiser Family Foundation. Thirty-six percent say it won't make much difference.

A slow rollout

A fact sheet released recently by the White House estimated that the extension of dependent coverage alone will "bring relief for roughly 11,400 individuals in Minnesota."

However, the changes don't happen for everyone at the same time. Because of the many compromises made as the Democrats tried to make changes on top of an existing system, the rollout will be patchy. While the benefits will be widespread, some will feel them sooner than others.

Take the expansion of dependent coverage. Most young adults are healthy and incur little in medical costs. But without insurance, all it takes is one accident or unexpected diagnosis to send an entire family into debt.

With the job market weak, parents are anxious to keep their kids on their coverage as long as they can. When the new provision takes effect depends on what kind of insurance someone has and what the person's employer decides to do.

"Expectations are very high and understandably so," said Julie Brunner, executive director of the Minnesota Council of Health Plans. But, she added, "it's a process."

A few years ago, Minnesota raised the age of dependent coverage to 25, but that applied only to the individual and small-group market. Large, self-insured companies, which are governed by federal not state laws, set their own limits on dependent coverage. They usually allow dependents to stay on the company plan until they graduate from college or until age 24.

After the federal health law passed this spring, Minnesota health insurers agreed to extend coverage early, partly as a goodwill measure and partly to save the paperwork involved in removing a child from a parent's plan only to have the child reinstated again. That alone kept saved 2,600 25-year-olds from being kicked off their parents' coverage, according to the Minnesota Council of Health Plans.

But again, that only applied to those in the individual and small-group markets. At large, self-insured companies, the rollout could take months.

Industry officials acknowledge it's confusing, but note that this is what happens when health care changes are overlaid on a complicated employer-based system.

"We're trying to establish a new framework over an existing framework and you don't want to disrupt in any way the continuity some people already have," Brunner said.

So while Sept. 23 has been bandied about as the magic date when everything takes effect, it's really more of a rough estimate.

Some self-insured companies are complying at the start of the new plan year. At Minneapolis-based Target and Richfield-based Best Buy, that's April 1. Meanwhile, Bloomington-based HealthPartners decided to implement the rule before the September deadline.

Then there are the employees who work under a collective bargaining contract -- they may have to wait until their contract expires.

Early mover

At Minneapolis-based Graco, which makes fluid-handling equipment, the company made a decision soon after the health law passed to extend benefits for dependents early.

In the past, Graco covered employees' kids up to age 19 or, if they were full-time students, age 24. Some 1,850 Graco employees are eligible for benefits and of these, 85 percent are signed up.

On July 1, Graco added 94 dependents to the company's group plan, bumping up costs by 1.5 percent. "It really is nothing," said Kristy Lucksinger, the company's director of benefits. "They tend to be the least expensive to insure."

The Kvinges of Lino Lakes were doubly lucky. Dan Kvinge is a manager for quality and technical services at Graco. Their son John, a full-time student at the University of Minnesota Law School, turned 24 this year. Meanwhile, their daughter Anne, 22, graduated from the University of Iowa in May and is looking for a job.

Both were set to be removed from Graco's plan, for which the family pays about $200 a month. Graco pays 80 percent of the premium for employees.

Dan's wife, Kathy, researched insurance options for both kids and settled on a health plan called Simply Blue, offered by Blue Cross and Blue Shield of Minnesota. It would cost $130 in monthly premiums for each kid. The plan came with a $5,000 deductible, did not cover maternity or substance-abuse services, but did cover some preventive care.

But then Graco stepped in and decided to extend coverage early.

Now both Kvinge kids are staying on their parents' plan at no extra cost to the family.

Chen May Yee • 612-673-7434