With the recent Supreme Court decision upholding vital components of the president’s Affordable Care Act, it is timely to review how health insurance coverage factors into divorces.
The Illinois Spousal Continuation Law is the state statute designed to protect a spouse and dependent children who lose group health insurance coverage due to death or retirement of the employee, or divorce from the employee, through whom they received coverage (i.e. the other spouse). It applies to Illinois group insurance and accident health plans offered to employees regardless of the size and to fully insured Illinois HMOs. It, however, does not apply to those who are self-insured employers or are part of self-insured health and welfare benefit plans (i.e. union plans). The Act is triggered when the individual holding the insurance divorces his/her partner, but the partner and dependent children were covered by the insurance plan prior to the petition for a divorce being filed.
In order to preserve your health insurance coverage in these circumstances, the eligible spouse (i.e. the one losing coverage because of the divorce) must notify the insurance company and employer in writing of the pending divorce within 30 days of it happening. The employer then has 15 days to notify the insurance company. The insurance company then has 30 days to notify the spouse of the right to insurance continuation. With this notice, you, as the requesting spouse, will receive a form that allows you to elect to continue the insurance coverage. You must return this form within 30 days of the insurance company mailing it.
This coverage continuation, however, is not permanent. It will last for two years if you are under the age of 55, or until you are eligible for Medicare if you are over the age of 55. It also will terminate if you remarry, do not make your premium payments, or become an insured employee elsewhere.
Spouses may also pursue health insurance continuation under COBRA, which is the continuation coverage provided under federal law. COBRA, however, only applies to insurance with employers who have more than 20 people on staff. Former spouses and dependent children are eligible for COBRA coverage. As a former spouse, your COBRA coverage eligibility triggers when you divorce or are legally separated from a covered employee. COBRA will allow the divorced spouse to maintain his/her coverage for up to 36 months.
It is no surprise, however, that navigating the health insurance process is challenging when going through a divorce. An experienced divorce attorney can walk you through your options to ensure you and your children remain adequately covered during the separation and divorce proceedings. Please contact our skilled DuPage County divorce lawyers today to discuss your case and to learn how we can be of assistance.