Most individuals are justifiably concerned about health insurance coverage both before and after a marital separation. Having good health insurance is important, particularly for children, and the costs can be substantial. When a divorce becomes final, it is typically considered a triggering event, which terminates coverage from a spouse’s employer, and starts eligibility for other coverage under COBRA and President Barack Obama’s health care law, even when it is not an open enrollment period. Maintaining health insurance coverage and planning for the expense is a very important consideration in support and divorce cases. The Pollock Begg team of lawyers is prepared to deal with health insurance coverage issues in these cases.

Will my spouse have to pay the premium?

Under the Pennsylvania support guidelines there is a calculation by which the cost of health insurance coverage is allocated between the parents or spouses in accordance with their net monthly incomes (or earning capacity if applicable). A parent’s share of the premium is added or subtracted to the basic support obligation as applicable.

Can my spouse take me off his or her insurance?

When the divorce is final, the short answer may be yes, therefore advance planning is important. If one spouse provides coverage through employment, while spouses are still legally married, but separated, the divorce courts will require the spouse to continue to carry the other spouse and kids, in most cases. There is a provision under the divorce code of Pennsylvania which gives a spouse the right to request an order directing the other spouse to continue to maintain health insurance coverage until the conclusion of the case. Typically, the cost is allocated between the spouses in proportion to their net incomes.

During separation and even after a divorce, minor children must be covered, in most cases, by the parent who provided health insurance during the marriage and separation period. Again, the premiums are allocated between the parents in proportion to their incomes and added to the child support obligation (or subtracted, depending on which parent provides coverage).

Will I have coverage after the divorce is final?

Some people are under the mistaken belief that their former spouse will be ordered to maintain health insurance coverage for them after the divorce is final. This is usually untrue for a number of reasons and might not be a good practice even if it were possible. First, the former spouse is no longer a dependent in insurance terms, so the cost may be much higher. Second, most employer-provided health plans do not have a provision for nonemployee exes. Third, there is too much risk the policy premium may not be paid, and coverage might lapse without warning (which you might discover when you receive a bill from the doctor or hospital).

For many spouses, the best approach may be to investigate the cost for similar coverage through a private policy and then compare that cost to COBRA health insurance law coverage. Consolidated Omnibus Budget Reconciliation Act is a federal law that requires most employers to offer continuation coverage to ex-spouses for a period of 36 months from the divorce decree. This cost might be added to the alimony obligation if agreed by the spouses or ordered by the divorce court.

Years ago, COBRA coverage (mandated by the Retirement Equity Act of the 1980s) was quite affordable, and most spouses opted to continue their previous coverage for the maximum 36 month time. Also, back in the time when pre-existing conditions mattered, COBRA coverage sometimes was the only option. A spouse electing this COBRA coverage pays the employer directly for the insurance, but there is no requirement of a monthly invoice, so it is your responsibility to make your monthly premium payment on time.

Today, with the Affordable Care Act, the health insurance marketplace contains many options to review before falling back on COBRA coverage out of habit. Pre-existing conditions will not prevent former spouses from obtaining health insurance, and coverage is available from a variety of different insurance companies at many different price points and coverage levels. The lawyers at Pollock Begg understand the health insurance calculation and can advise you as to the amount it will affect your support or divorce case.

Contact Pollock Begg to schedule an appointment to discuss the health insurance calculation as it relates to your case.

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