What Happens To Health Insurance In A Legal Separation Proceeding?

 When going through a legal separation proceeding, you would give some of the significant issues an excellent thought. These may include support, property division, child custody, and asset distribution. However, you may easily skip on your health insurance.

It is worth mentioning that your health insurance is affected by your legal separation proceedings.


Keep reading to learn more.

 Would your Health Insurance be Terminated?

Well, when you file for a divorce or legal separation, there are specific orders that come into effect automatically. Usually known as Automatic Temporary Restraining Orders, they prevent your spouse or partner from altering any insurance coverage. Notably, these restraining orders are only effective until the judgment is served.


On the other hand, when the separation is served, it would generally cause you to lose insurance benefits, especially if you are a "dependant" on your separating spouse's health insurance. Most insurance plans consider legal separation as the same for divorce. However, depending upon your particular divorce case, you may be entitled to other benefits. For instance, if you are filing for a military divorce, you may seek other health plans or benefits. But, they would also depend upon specific eligibility criteria.


Nonetheless, it would be safe to say that you'd lose your health insurance benefits after you are legally separated in most cases.


What if your Marital Status is Terminated Early?

As already mentioned, in some cases, you might still be able to enjoy the benefits of your spouse's health insurance. Generally, the courts include conditions in an early grant of dissolution of the marriage. In most cases, the conditions make it mandatory for one spouse to maintain the existing health insurance coverage. And in case the insurance is not maintained, the spouse may need to cover medical expenses. [Family Code § 2337(c)]


Is there any Legal Requirement to Continue the Coverage?

Although the courts may interfere and order your spouse to maintain your medical insurance, you can do the needful on your own if they do not. There is some legal paperwork that you may need to complete to continue enjoying the existing coverage. In either case, the insurer would need to be informed about the same. Since most insurers consider legal separation and divorce the same way, the insurer may automatically forfeit the dependant's benefit if the needful is not done.


You would need to share a copy of the judgment with the insurer along with a notice informing the insurer about the court's order. The notice and court's order would generally mandate it for the insurer to send you notice of any change in coverage of the policy. [Family Code §2051].


How do you Remove your Spouse if they are a "Dependant"?

To remove your spouse from your insurance coverage as a beneficiary, if the courts have not placed any restrictions, you'd need to follow a similar process as before. The only difference would be the timeframe and the legal notices that you'll be sending.


If you are the prime beneficiary, it is your responsibility to inform your insurer about separation. And that too within 60 days of court's judgment. [29 U.S.C. §1166(a)(3)]


You would also need to share a copy of the court's notice with your insurer. The notice should set forth the summary of the separation order within 90 days of the commencement of your coverage plan. [29 C.F.R. §2590.606-1(b)(1)(i), (c)(3), (e)]


What Protections are Available to you if you are Removed as a Dependant on your Spouse's Health Insurance?


It is worth mentioning that some federal and state laws can offer you the protection you need. The protections offered include:


  1. Being disqualified because of divorce from covered employee health coverage is prohibited. Or, at least, the employer must offer a conversion option; otherwise.

  2. Spouses covered under group policy must be offered a conversion plan in case they become ineligible.

  3. There are federal plans in place that offer continued health insurance for former spouses. However, the federal plans have strict guidelines and deadlines for application.


The protections mentioned above are subject to availability and eligibility. And since these protections are not easy to obtain, it is better to confirm these with your attorney. Or you can contact your insurer directly.


Apart from these benefits, there is one more option - COBRA.


What is COBRA and How it Works?

Consolidated Omnibus Budget Reconciliation Act, abbreviated as COBRA, was introduced in 1985. It is, indeed, a part of the Employee Retirement Income Security Act of 1971.


COBRA was introduced to confirm the right to continued health insurance coverage for any individual. Even in the case of dissolution of marriage or legal separation, regardless of employment status.


Under COBRA, separated spouses can enjoy continued coverage of health benefits. However, the benefits are not offered to domestic partners. In certain events, or as deemed fit, seeking benefits for domestic partners can result in termination of plan benefits. Or reduction of plan benefits to the least. [ERISA §§ 601-609; 29 U.S.C §§ 1161-1169]


Besides, the insurance or the health benefits are limited to three years under COBRA. This holds true only if you apply for the benefits within 60 days of the dissolution of your marriage or legal separation. [29 U.S.C. §§ 1162(2)(A)(iv), 1165(a)(1)]


On top of that, your spouse's employer is not needed to subsidize your insurance. Instead, they can charge 102% of the cost from you. [29 U.S.C. § 1162(3)]


You would need to consider these increased costs, along with the cost of non-subsidized health insurance, but only after COBRA coverage ends. It could be a detrimental factor for your post-dissolution needs.


In case you are the employed spouse, you would need to inform your employer about the dissolution of your marriage. Your employer would then initiate your spouse's eligibility for COBRA coverage.


By now, you would have come to terms with most of the possible scenarios concerning your health insurance post-separation. However, we would still recommend you consult with your attorney to understand the intricacies involved.

No comments