If you’re facing divorce as a Rhode Island resident, you’ll need to be well versed on your rights and options regarding health insurance. Generally, one spouse can’t remove their partner from a shared health insurance plan until the divorce is final. However, what happens following the Final Judgment of Divorce is a different story.
While the Rhode Island Health Insurance Continuation Act is in place to allow a person to remain on their ex-spouse’s health insurance after the Final Judgment of Divorce, ERISA (Employee Retirement Income Security Act) often overrules this Act. ERISA is a federal law that sets minimum standards for health plans in private industries to protect individuals under these plans. This means health insurance coverage following the Final Judgment of Divorce is not always guaranteed.
While awaiting a divorce settlement, the parties should seek the employer’s policy and procedures related to the continuation of coverage from the company’s benefits administrator. If it is determined that the benefits will be extended to an ex-spouse following divorce, that should be “put on the record” and into the Decision Pending Entry of Final Judgment as well as the Final Judgment of Divorce. Typically we say something like:
“Plaintiff shall provide Defendant with Health Insurance and Dental Insurance pursuant to the Rhode Island Health Insurance Continuation Act.”
In the event an insurance company will not continue coverage once a divorce is finalized, alternative coverage will be needed. Keep in mind that the law is not such that it can compel a private third party individual or business, to maintain health insurance for a divorced spouse, unless that individual or business voluntarily agrees to do so.
The law is directed only to the parties of the divorce, the spouses, and forces one spouse to maintain coverage for the other so long as it is available to them. It does not however apportion the cost of the maintenance of coverage and that is typically negotiated as part of the Divorce.
Below are a few common health insurance options available to individuals following divorce.
Employer Health Insurance Plan
In many cases, seeking coverage under one’s own employer will be the most cost-efficient option. However, many employer-sponsored plans have specific enrollment periods. In the event your loss of coverage does not coincide with an enrollment period, some plans will offer a special enrollment due to divorce. Consult your Human Resources or Administration office for health coverage options and details.
COBRA coverage is a viable option when you’ve already incurred significant medical expenses during the year. Unlike a brand new policy with new out-of-pocket limits, COBRA allows you to retain coverage under the same plan you already have, but separately from your ex-spouse.
There are specific requirements that must be met in order to qualify, however. For instance, your ex will need to work for a company with 20 or more employees to be eligible for COBRA, and you must apply for COBRA coverage within 60 days of your policy termination. Additionally, this can be the most expensive option. For this reason, it’s important to price shop health insurance options.
Affordable Care Act
The Affordable Care Act is a government-run exchange for individuals who cannot afford COBRA and are not eligible for employer-sponsored coverage. Like COBRA, you have 60 days following your divorce to get coverage. This period is known as the Special Enrollment Period. If you do not enroll within 60 days, you will have to wait for open enrollment to sign up, which typically runs at the end of the year.
While health coverage may be the last thing on your mind when going through a divorce, it is essential that you research your options, so you aren’t left without coverage. For more advice regarding your Rhode Island divorce, please contact our office.