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A Service of OnQue Technologies, Inc. |
| Ex-spouse Claims Entitlement to 36 Months;
Broker and Carrier Disagree |
March 6, 2006
By Scott Haines, President
OnQue Technologies, Inc.
Santa Rosa, CA |
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The
following is an excerpt from Questions and Answers from the COBRA Help Desk–Part
II.
Broker: An employee left a client company
and she and her husband went on COBRA for 18 months. Three months later, she
joined her new employer's plan and her husband stayed on COBRA. In May of 2005
they divorced. At the end of August 2005, the ex-husband's 18-month COBRA
period expired. The ex-husband maintains that he is entitled to another 18
months of continuation due to the divorce. But the divorce caused no loss of
coverage - the end of the continuation period did, and therefore I feel that he
is not entitled to any additional continuation, either from the divorce or from
the end of the continuation period. The employer agrees with me, as does the
insurance carrier involved. However, the ex-husband's attorney says that he is
entitled to additional coverage. Who is right?
OnQue: Whether the former
spouse in this case is entitled to the 18-month extension depends upon the
following:
- The divorce must have occurred
before the qualified beneficiary's original 18-month coverage period expired.
That requirement appears to be satisfied in this case.
- The qualified beneficiary must
have notified the plan of the divorce within 60 days of the divorce decree
date, provided the plan properly disclosed the notice requirement to the
qualified beneficiary in its Summary Plan Description and in the initial
Qualifying Event Notice. Otherwise, the 60-day notice requirement is not
enforceable.
I assume from your description of the case that the
plan administrator did not learn of the divorce within the 60-day notice
period. If that assumption is valid and if the plan administrator can verify
that the former spouse was properly informed of the notification requirement,
then he is not entitled to the extension.
I would urge your client to
obtain legal advice before taking any action. Because the denial of COBRA
continuation coverage is a serious matter, verification that the employer has
met its disclosure obligations is critical. On the other hand, offering such
coverage when not required by law sets a dangerous precedent, because in so
doing the plan administrator is making an exception to the 60-day notification
requirement. That decision could result in an obligation to provide the same
extension of the notification period to all individuals who experience a second
qualifying event. Also, the insurers would have to agree to provide extended
coverage under such circumstances. |
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| Related COBRA Tips |
| Do You Provide
Terminated Employees with Adequate and Timely Benefits
Information? |
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This information is provided by
OnQue Technologies, Inc. for educational purposes only and does not constitute
legal advice. If legal advice or other professional assistance is required, the
services of a competent professional should be sought.
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