Indiana Health Care Coverage For Spouse

[FroggiesMimi]

I have a friend who is 62, collects $700.00 per month in 100% SSI Disability and has been married, for 15 years, to a 47 year old healthy man who made over $60,000.00 last year. The husband was abusive and has admitted to cheating on her. She has finally left him and is worried about the implications of filing for divorce as relates to her insurance coverage. She is covered under her husband's health care plan. In Indiana, does the spouse who has the insurance coverage required to maintain that coverage during separation, before a divorce is final. Also, what are the laws regarding the covered spouse being ordered to maintain health insurance AFTER divorce ?
Thanks.

 

[cbg]

It is unlikely that any hard and fast law exists that declares health insurance will ALWAYS be handled exactly the same way with regards to who has to maintain it and for how long. In any state. The court will be looking at a number of variable factors before deciding what to do.

However, I can give you some basic information based on Federal law. These answers assume that the husband's insurance is through his employer and that his portion of the premium is taken out pre-tax. If that is not the case, the answers do not apply.

Changes to an insurance enrollment can take place at only two times; within 30 days of a qualifying event (marriage, divorce, birth, death, adoption, loss of job/already existing coverage) or at open enrollment. Open enrollment happens once a year, but it could be at any time of the year. During the open enrollment period, which is generally a month or two before the start date, any employee can add or subtract coverage, add or subtract dependents, change to a different plan, etc., with no questions asked. January 1 and July 1 are the most common start dates, but nothing in the law prohibits it from being August 7 or April 24. So whenever open enrollment occurs, he can drop her from the coverage effective the start date and there's nothing she can do to stop him.

Outside of open enrollment, though, legally he can only drop her within 30 days of a qualifying event. I have listed above some events that are always qualifying; however, it is possible that a legal separation or some other events related to an upcoming divorce might or might not be. Those events will be spelled out in the plan document; if they are not listed in the plan document, then they are not qualifying events. He cannot just do it on a whim. This is Federal law.

If her coverage is terminated based on a qualifying event and the employer has 20 or more employees, they must offer her the chance to retain the coverage for up to 36 months at her own expense (COBRA). Some states, mine for example, provide for a longer period but I do not know if Indiana is one of them. She would have to ask the Indiana DOL or insurance commission. If she is dropped from the coverage as part of open enrollment, it is my understanding that many employers will offer COBRA anyway but that it is not required.

One thing she needs to keep in mind with reference to the above, is that a court order is binding on the husband, not the employer. If the court orders him to provide her with insurance and she's already on the plan, no problem. But if she's been removed from the plan and the court orders him to provide her with coverage, if it is not within 30 days of a qualifying event and it is not open enrollment, the employer has no legal obligation to violate their contract with the carrier (and Federal law) to add her to the plan. It would be the husband's responsibility to find a short term policy until either the divorce is finalized (divorce is always a qualifying event) or open enrollment, whichever came first.

Hope this helps.