Health Insurance Coverage for Spouse - COBRA

In many marriages, one spouse gets health insurance through his or her employer and the other spouse is covered under the plan.  Children are also normally under the insurance plan.

The problem: one spouse listed as family under the health plan normally gets dropped after the divorce.  The children can usually remain under the plan.

Here is the common misconception:  the couple can agree to keep the non-primary spouse on the plan after divorce OR the court can order the coverage to continue.  The actual truth is this type of arrangement is impossible.  After divorce, the former spouse is an independent adult and is not eligible to remain on the same health insurance policy.  Even if the two of you agree to this type of arrange, the insurance company will put a stop to it and drop the non-primary person from the policy.   You can remain on the family policy during the divorce.  Many divorces include a temporary support order that can address health insurance issues.

The solution:  The non-primary spouse can elect COBRA coverage (Consolidated Omnibus Budget Reconciliation Act).  COBRA is a federal law that requires insurance companies to provide continued access to health care coverage to people who qualify.  It is a temporary solution, available for up to 36 months.

COBRA is available to anyone going through a divorce or legal separation from an employee that is currently covered by a health plan.  There are other people who qualify, but for the purposes of this article we will only talk about divorce or legal separation.

Here is the downside to COBRA – it can be dramatically more expensive than the premium offered by the employer.  So COBRA is only practical when someone has the ability to pay the premium.   The main advantage of COBRA health coverage is that it can still be cheaper than individual plans and you cannot be denied coverage.

 

What group health plans are subject to COBRA?

   The health plans covered by this law are health plans maintained by private-sector employers with 20 or more employees, employee organizations, or state or local governments.  

How to get COBRA coverage:

   A qualified spouse must notify the plan administrator within 60 days after divorce or legal separation or a child's ceasing to be covered as a dependent under plan rules.

   Plan participants and beneficiaries generally must be sent an election notice not later than 14 days after the plan administrator receives notice that a qualifying event has occurred.  The individual then has 60 days to decide whether to elect COBRA continuation coverage.  The person has 45 days after electing coverage to pay the initial premium.

Contact info:  

   Divorced spouses may call their plan administrator or the EBSA Toll-Free number, 1.866.444.EBSA (3272) if they have questions about COBRA continuation coverage.

Can I get my divorcing spouse to pay for Health Insurance under COBRA rules? 

   Health Insurance coverage is in the nature of alimony or spousal support.  In general, if your spouse has a duty of alimony, part of the support obligation may be paying for health insurance coverage.  When there are children there is almost always a duty to provide health insurance for them.   You should review the rules on alimony to determine if you have a right to support.  Then find out what the health insurance premium would be under COBRA.  The premium must make sense as part of the overall support package.

The Divorce Center can provide an experienced divorce attorney for your entire case or any individual part. Tampa, Pinellas, Pasco, Hernando County Divorce Attorney Howard Iken will give you personal attention, fast answers, and the loyal aggressive representation you need. We also offer a forms preparation service with lawyer review and consultation for reasonable prices. Check out our easysavr legal service. CONTACT US NOW or call 888-469-3486