2008: a year of expanded coverage.

The new state law expanding the definition of dependents who can be covered by an employee's health insurance isn't the only change that will be expanding the coverage of family plans in the coming months. By the end of the next year, such plans will have to:

* Cover divorced spouse for three years

* Cover partners in same-sex civil unions

* Pay for early intervention therapy for delayed children under the age of 3

Like the dependent coverage, no one really knows the cumulative costs of these reforms and how they will affect premiums, particularly those of family plans.

While supporters of the laws say they will help reduce the number of uninsured, thereby reducing costs in the long run, opponents contend that they can increase the cost of family plans so much that they might result in both employers and employees dropping them altogether.

"More mandates," complained Rep. John Hunt, R-Rindge, who is sponsoring a bill that would repeal the laws allowing coverage of spouses and older dependents.

Hunt reserves his biggest criticism for the developmental disability law, which went into effect Sept. 14. Schools are mandated to provide such coverage after 3 years of age, and it has been the state's job to offer such services earlier, though its coverage has been somewhat spotty. Now private family insurance plans must pay as much as $3,200 a year for occupational, physical and speech therapists, as well as reimburse pathologists and clinical social workers from birth until 36 months.

Supporters said that early intervention can prevent more costly interventions later on. But Hunt said it might encourage intervention before anybody really knows if it is necessary.

"This could be a huge cost driver" said Hunt.

Beth Roberts, vice president-northern New England for Harvard Pilgrim Health Care, agrees that the early intervention bill is "quite significant?'

"We didn't have a network of providers," she said, "so we have been working to provide one ever since its passage."

The divorced-spouse law, which goes into effect Jan. 1, is aimed at another segment of the uninsured. The idea is that divorced spouses--especially those not working--need some coverage until they can get on their feet. The coverage could end earlier, if it is put in the divorce agreement or if either party remarries.

However, this could create a sticky, tax situation, similar to that faced by families considering adding their young adult children (see adjoining article). The Internal Revenue Service does not consider divorced spouses health-care dependents, thus an employee might have to pay thousands of dollars in taxes for his or her ex's benefit. Considering that divorces spouses have trouble agreeing on anything, this might be another source of tension.

Theoretically, it is still up to the employee to add his ex-spouse as a dependent. and the employer doesn't have to listen to a dependent demanding to be covered. That all should be worked out in family court. But in small workplaces, it might be hard for an employer not to feel caught in the middle.

The civil unions law, perhaps the most controversial in the mind of the general public, might have the smallest effect on employers and insurers when it goes into effect Jan. 1.

Many plans already offer some kind of same-sex couple benefits. And while the tax consequences are the same--civil union partners can't be claimed as federal tax health dependents--a couple choosing to make a civil union is more likely to come to an agreement than those who are breaking up their marriage.