| Health insurance issues must be considered in matrimonial actions. In some jurisdictions, as a matter of law, one must pay for the medical necessaries of one's children and spouse even during legal separation. The requirement of paying for a spouse's medical necessaries may be satisfied by fulfilling whatever obligations are laid down in a separation agreement or decree. Most courts have had no trouble finding the authority, inherent or statutory, to require the maintenance of a health insurance policy. An order to maintain insurance is a continuing personal obligation for that party. A number of states have enacted laws requiring that health and accident insurance policies that terminate upon divorce contain a conversion privilege for the divorced spouse.
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)
In 1985, Congress enacted the Consolidated Omnibus Budget Reconciliation Act (COBRA), which requires certain employers to provide their employees and covered family members with health insurance at group rates upon the happening of certain ''qualifying events.'' The termination of employment, the divorce or separation of the covered employee from his or her spouse, or death of the covered employee, are qualifying events.
Compliance Required by Law
The law requires compliance by companies that have at least 20 employees, with certain exceptions. These employers must continue to make their medical coverage available at group insurance rates for 18 months where the ''qualifying event'' is the termination of employment, and for 36 months, where such event is the employee's death or divorce. Thus, the ex-spouse and dependent children have the right to purchase group-rate insurance for as long as three years. Employees and their families are not eligible if they have any other health insurance, such as Medicare. Federal employees are not covered, nor are families of workers who have been discharged for ''gross misconduct.''
Compelling Compliance
To compel compliance, Congress has provided that the employer can be sued under the Employers Retirement Income Security Act of 1974 (ERISA) and can be denied corporate tax deductions relating to health benefits. If a company refuses to provide continual coverage as ordered by the statute, certain top officers and certain highly placed employees could be taxed on their own health benefits. COBRA shifts some of the cost of medical insurance away from the individual and onto the employer. It also makes insurance available to some individuals who might not otherwise have qualified. Copyright 2010 LexisNexis, a division of Reed Elsevier Inc. |