Question:
Insurance Issue

I have decided to leave my husband and was just approved for surgery through his insurance. Can they deny me coverage if I leave him beore the surgery? The company pays for the insurance and my surgery is in a few weeks. His company will be getting new insurance on 1/1/03. This is right after my surgery and I read that divorcees can get cobra coverage. Any advice?    — victoria B. (posted on December 9, 2002)

December 9, 2002
First of all, speak to a lawyer about the laws and traditions in your state. I am assuming that you have not drawn up a separation agreement etc. This is not legal advice, but from what I've experienced myself and what I have heard of from others, insurance issues are typically dealt with as part of a divorce agreement. It is my understanding (and I could be wrong in regard to your state and your situation) that separating spouses are still legally married and continue to be covered. You can ask the insurance company about this. In the divorce agreement, insurance is normally dealt with. Courts typically do not like to leave spouses uninsured and a lot of divorce agreements stipulate that the spouse is insured until the insurance-carrying spouse remarries. Medical insurance tends to be a very major point of most separation and divorce agreements. If you have a lawyer, ask about this and if you do not, I would find one to ask about this. Some plans might let your spouse cancel you if there is no reason to prevent it.
   — susanje

December 9, 2002
Divorcees are eligible for Cobra probably 36 monthes-- definitely for 18 months. However, this does not apply if the company is small. I don't know what the size has to be, but you can find it out. However, I know that Cobra coverage comes from the insurance you have at the time of the qualifying event (ie., either the separation or the divorce, you'll need to check). In other words, if the qualifying event is the divorce, your COBRA coverage may be with the new insurance. Also, you should know that under COBRA, the employer can charge you for the costs of the insurance, up to a certain limit.<br> A good place to read the basic COBRA rules is on the US Department of Labor website for specifics-- go to the Pension and Welfare Benefits Administration, which is a subdepartment of the DOL, and regulates (and enforces) COBRA. Most of their published information can be read and understood by non-lawyers. <br> Talk to your divorce attorney about this issue, especially on how this is affected by the divorce laws in your state, and how you can best negotiate with your husband to your advantage.<br> Good luck!
   — Beth S.

December 9, 2002
COBRA coverage is available to ex-spouses for I believe 36 months. Divorce is considered a qualifying circumstance therefore the 36 and not the 18 months. The only way they can deny you coverage if you leave him before surgery, is if he removes you from the policy. At that point you have 60 days to sign up for COBRA, and your coverage would be retroactive to the date he removed you.
   — RebeccaP

December 9, 2002
ooops I posted the same time Beth did. The company your husband works for is the one that you will pay for the cobra coverage. They can charge you 102% of the policy premium for your coverage. The 2% is optional for the company to charge you. It is for admininstative fees. Some states however will not allow this 2%.
   — RebeccaP

December 9, 2002
I would certainly speak with an attorney. Being a Human Resources Manager, I have come across situations in certain states where a spouse can drop you and you won't even know it. For instance, this could happen if you are in a state that does not have legal seperation and you decide to separate for a period of time. (I'm not sure about what state you're from.) Your spouse could drop you from his policy while you are still technically married; he wouldn't even have to tell the company why he's dropping your coverage. When it came time for the divorce where you/he would notify the company and COBRA would usually be offered, you will have lost your right to COBRA. The cases that I've seen were vendictive spouses dropping coverage just to spite the soon-to-be ex-husband or ex-wife. To protect yourself, I'd check with your attorney depending upon what type of relationship you have with your husband.
   — lezawomack