Many families elect to have Group Insurance coverage under a single spouse provided by their employer. This means one spouse is the primary policyholder of a medical insurance plan, and the rest of the family is covered under that one plan. During a divorce, the question arises as to how the other spouse, and children, will be covered by medical insurance.
Massachusetts law does allow the dependent spouse to remain on the insured spouse’s private employer-sponsored group plan after divorce and legal separation. However, this only applies to insured plans. This is why it is important to understand the type of coverage fulfilled by a policy.
For example, employer-sponsored group health plans may be either insured or self-insured. Insured health plan coverage is purchased from an insurance carrier or managed care organization (such as an HMO), by the employer. A self-insured (or self-funded) plan, on the other hand, places the financial risk for employee medical claims on the employee and where an insured spouse’s employer is self-insured there is no legal requirement for that employer to keep the ex-spouse on the plan after divorce.
To continue coverage, the covered spouse (or lawyer) will disclose the coverage type in the summary plan description. If the obligor spouse has employer-sponsored group health insurance that will cover the other spouse, the Separation Agreement or court order must generally order the policyholder to extend coverage to the dependent spouse.
Under Massachusetts law, state insurance allows the dependent spouse to remain on the insured spouse’s private employer-sponsored group plan after divorce and legal separation. However, coverage ends when the dependent spouse remarries. In some cases, the judgment may provide for coverage to continue after the insured spouse remarries.
For help managing the complexities of things that can come up in a divorce such as this, contact our expert attorneys who are well versed in Massachusetts family law.