Under New Hampshire law, health insurance benefits through your employer can be continued for your spouse and children following a divorce. It is important that appropriate procedures are followed to be sure that there is no gap in insurance coverage and that needless costs are not incurred by either party.

Effective January 1, 1997, the statute allows continued coverage so long as the employee meets certain conditions. First, the employee must have been employed for at least six months if eligibility is based on employment. Otherwise, when an individual who has been insured for at least six months, and is a member of any group medical insurance plan or health maintenance organization, becomes eligible for continued participation in the plan for any reason including death, except dismissal for gross misconduct, the benefits of the plan shall be available at the same group rate to a divorced spouse or legally separated spouse of a covered employee, for an extension period of 36 months.

When the surviving spouse, divorced spouse, or legally separated spouse of a covered employee is 55 years of age or older, then the extension period shall continue until the surviving spouse, divorced spouse, or legally separated spouse becomes eligible for participation in another employer-based group plan or becomes eligible for Medicare or until the remarriage of either the member spouse or the former spouse, whichever occurs first.

The divorced spouse, legally separated spouse, or dependent must make an election to continue the participation in the group plan. With respect to a divorced spouse or legally separated spouse, the extension of group coverage shall be provided without additional premium or examination, as if the decree had not been entered, however, the premium may include an administrative fee not to exceed two percent of the monthly premium to the employer or policy holder throughout the extension periods.

Any divorced spouse or legally separated spouse who is responsible for making a portion or full payment to the employer shall notify the employer and the insurance company, in writing, within 30 days of the decree of divorce or separation, that coverage under this statute is requested. Any employee who is responsible for making a portion or full payment to the employer shall likewise notify the employer and the insurance company, in writing within 30 days of the decree of divorce or separation, that coverage under this statute is requested. The employer has the right to terminate coverage for a former dependent spouse who is receiving coverage under this statute if any payment for the coverage is not received from the former dependent spouse within thirty days of the date the premium payments are due. If any payment for the coverage for which the employee is responsible is not received from the employee within 30 days of the date the premium payments are due, the employer has the right to terminate coverage for a former dependent spouse; however, no such termination may occur without thirty days' prior notice to the former dependent spouse, during which time the former dependent spouse has to be given an opportunity to make the payments due or to secure payment from the employee.

Upon termination of the relevant extension period, the divorced spouse, legally separated spouse, or dependent is entitled to exercise any option which is provided in the group plan to elect a converted policy. This is likely to be an individual policy. If the divorced spouse, legally separated spouse, or dependent makes timely payments, and the employer fails to make payments to the insurer or health service corporation or health maintenance organization, and the result is that coverage is terminated, the employer will be liable for benefits to the same extent as the insurer or health service corporation or health maintenance organization would have been liable if coverage had not been terminated.

It is critical that parties in a divorce or legal separation follow appropriate procedures to ensure continued health insurance coverage for a spouse. Prior to issuance of a decree, the dependent spouse needs to have been covered under the group health insurance plan to be eligible for continued coverage. The divorce decree should explicitly state who will pay for the continued health insurance coverage. It is a good idea to check with your employer to be sure all necessary documentation is completed to ensure continued coverage.

The attorney who wrote this article is no longer at the law firm of Hamblett & Kerrigan, P.A. in Nashua. Other practitioners at the firm handle work in the same areas of law which he worked in, which included employment law, family law, and general litigation, including property tax abatement and personal injury.You can reach one of those lawyers by calling the law firm (883-5501) or by e-mail at info@nashualaw.com .

This information is general information and may not reflect the most current legal developments, verdicts or settlements. The information provided should not be relied upon as an indication of the actual state of the law or of future developments. The information contained on the Hamblett & Kerrigan website is for informational purposes only and does not constitute legal advice. If the information referenced may be of legal importance to you, you should consult with an attorney to provide you with legal guidance and opinion as the the effect of the current law upon your situation.