SB 0197

CHAPTER 379

SB 197 – FINAL VERSION

AN ACT relative to continuation of group health insurance in the event of divorce or legal separation.

SPONSORS: Sen. Roberge, Dist 9; Sen. Burling, Dist 5; Sen. Hassan, Dist 23; Sen. Fuller Clark, Dist 24; Rep. McLeod, Graf 2; Rep. Dokmo, Hills 6; Rep. Pilliod, Belk 5

This bill requires continuation of group health insurance in the event of divorce or legal separation.

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

AN ACT relative to continuation of group health insurance in the event of divorce or legal separation.

Be it Enacted by the Senate and House of Representatives in General Court convened:

379:1 Group or Blanket Policy Provisions. Amend RSA 415:18, VII(e) to read as follows:

(e) The conversion provision shall also be available, upon the death of the employee or member, to the surviving spouse with respect to those family members who are then covered by the group policy, and shall be available to a child solely with respect to himself upon his attaining the limiting age of coverage under the group policy while covered as a dependent thereunder. The conversion provision shall also be available to a former dependent spouse upon remarriage of the group plan member, after exhaustion of continuation coverage pursuant to RSA 415:18, VII(g)(1), if applicable, and upon termination of the former spouse’s eligibility for group coverage under RSA 415:18, VII-b or RSA 415:18, VII(g)(1). A former dependent spouse shall exercise the conversion within 31 days of the remarriage of the group plan member.

379:2 Group or Blanket Policy Provisions. Amend RSA 415:18, VII(g)(1)(G) to read as follows:

(G) The individual, surviving spouse, divorced spouse, legally separated spouse, or dependent shall elect to continue the participation in the group plan according to rules adopted by the commissioner under RSA 541-A. The individual, surviving spouse, or dependent shall be responsible for payment of premiums which may include an administrative fee not to exceed 2 percent of the monthly premium to the employer or policyholder throughout the extension period. Any divorced spouse or legally separated spouse who is responsible for making a portion of 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 or such later date as is permitted under RSA 415:18, VII-b, that coverage under this subparagraph is requested. Any employee who is responsible for making a portion of 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 or such later date as is permitted under RSA 415:18-b, that coverage under this subparagraph is requested. The employer shall have the right to terminate coverage for a former dependent spouse who is receiving coverage under this subparagraph if any payment for the coverage is not received from the former dependent spouse within 30 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 shall have the right to terminate coverage for a former dependent spouse; however, no such termination shall occur without 30 days’ prior written notice to the former dependent spouse, during which time the former dependent spouse shall be given an opportunity to make the payments due or to secure payment from the employee. Upon termination of the extension period, the member, surviving spouse, divorced spouse, legally separated spouse, or dependent shall be entitled to exercise any option which is provided in the group plan to elect a converted policy. After timely receipt of the premium payment from the individual, surviving spouse, divorced spouse, legally separated spouse, or dependent, if the employer fails to make payments to the insurer or health service corporation or health maintenance organization, with the result that coverage is terminated, the employer shall 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.

379:3 New Paragraph; Group or Blanket Policy Provisions. Amend RSA 415:18 by inserting after paragraph VII-a the following new paragraph:

VII-b. Any group or blanket accident and health insurance policy covering a resident of New Hampshire shall contain the following provisions:

(a) Upon a final decree of divorce or legal separation, if one spouse is a member of a group or blanket accident and health insurance policy, the former spouse who is a family member or eligible dependent under said policy prior to the date of the decree shall be and remain eligible for benefits under said policy, without additional premium or examination, as if said decree had not been issued. Such eligibility shall not be required if the decree expressly provides otherwise.

(b) The former spouse shall be eligible for coverage pursuant to this section through the member’s participation in a group or blanket accident and health insurance policy while such policy remains in force or is replaced by another group or blanket policy covering the member, until the earliest of the following events occurs:

(5) Such earlier time as provided by the final decree of divorce or legal separation.

(c) Upon the occurrence of the earliest of the events set forth in subparagraph (b), other than remarriage of the former spouse, the former spouse shall have the right to continuation coverage under RSA 415:18, VII(g)(1)(C) and (D). An insurance carrier may charge a premium for the former spouse’s continuation coverage under this subparagraph, in accordance with RSA 415:18, VII(g)(1)(G). The former spouse shall request enrollment under RSA 415:18, VII(g)(1)(G), in writing, within 30 days after the first occurring of the events set forth in subparagraph (b), provided that the former spouse may not request enrollment upon remarriage of the former spouse. If the first occurring event is the member’s remarriage or death, the former spouse may request enrollment under RSA 415:18, VII(g)(1)(G), in writing, within 30 days after receiving notice of said event.

(d) In the event of the former spouse’s remarriage, the former spouse shall notify the insurance carrier, in writing, within 30 days after the date of remarriage, and the effective date of termination of the former spouse’s eligibility pursuant to this section shall be the date of remarriage.

(e) The member or former spouse shall submit to the insurance carrier evidence of the former spouse’s eligibility under this section within 30 days after the final decree of divorce or legal separation. If the group or blanket accident and health insurance policy existing as of the date of the decree is replaced by another group or blanket policy covering the member that is issued by a different insurance carrier, said carrier may request that the member or former spouse submit evidence of the former spouse’s eligibility under this section within 30 days of the effective date of the member’s coverage under the replacement policy. A former spouse’s coverage under the member’s group or blanket accident and health insurance policy pursuant to this section shall be effective as of the date of the final decree of divorce or legal separation in the case of a then existing policy, or, in the case of a replacement policy, the effective date of the member’s coverage under such policy.

(f) The former spouse shall notify the insurance carrier, in writing, of any address other than the member’s address to which notices and correspondence pertaining to the former spouse’s coverage should be mailed, including but not limited to notice of cancellation and any right to reinstate coverage, and the carrier shall use such address until it receives written notice from the former spouse of a change.

(g) Upon termination of the eligibility of a former spouse for coverage pursuant to this section, and the exhaustion of continuation coverage under RSA 415:18, VII(g)(1), if applicable, said former spouse shall be entitled to exercise any option which is provided in the group plan to elect a converted policy, as provided by RSA 415:18, VII(e), or to apply for individual coverage. If the group plan does not contain a conversion option, the former spouse shall have the right to apply for individual coverage and be referred to the high risk pool under RSA 420:G-5, V.

458:18-a Group Insurance Plans. Upon a decree of nullity [or], divorce, or legal separation, if one spouse is a member of a group health insurance plan and the employer or any other sponsor is responsible for the payment of the premium required by the insurer as the consideration for providing coverage to an ex-spouse, such premium shall be paid either by the health insurance plan member, the ex-spouse of the member, or by both the member and the ex-spouse as they shall agree or as shall be ordered in the decree of divorce by the court. The provisions of this section shall apply to dental coverage provided by such group health insurance plan and shall apply whether or not the ex-spouse is receiving child support payments. This section shall apply only to continued coverage under RSA 415:18, VII(g)(1) or 29 U.S.C. section 1161, and shall not affect or limit any rights of the former spouse under RSA 415:18, VII-b.

379:5 Contingent HB 921-FN; Definition; Continuation of Coverage; Termination of Coverage. Amend RSA 415:18, XV(c) to read as follows:

(c) “Individual” means any person covered under a group health plan, including but not limited to, the covered employee, the spouse of the covered employee, whether surviving, dependent, former dependent, divorced or legally separated; or the dependent child of the employee, and any other person including a child born or placed for adoption with the covered employee, who is covered under a group health plan through the employment relationship.

379:6 Contingent HB 921-FN; Continuation of Coverage. Amend RSA 415:18, XVI(c)(4)(B) to read as follows:

(B) The divorce or the legal separation of the covered employee or, if the employee’s former spouse has been covered pursuant to RSA 415:18, VII-b, the first occurring of any of the following events:

(iii) The 3-year anniversary of the final decree of divorce or legal separation; or

379:7 Contingent HB 921-FN; Continuation of Coverage. Amend RSA 415:18, XVI(g)(2) to read as follows:

(2) Where the employee’s spouse is also covered by the group plan, and there is a divorce or legal separation, the employee shall notify the employer of the divorce or separation within 30 days, and shall provide the employer and carrier with the employee’s spouse’s mailing address. In case of a divorce or legal separation, the carrier shall provide a separate notice of the right to continue to the divorced or separated spouse. The divorced or separated spouse may elect to continue coverage pursuant to this section by notifying the carrier within 45 days of the date of the notice and remitting the premium payment. The notice and election provisions of this paragraph shall also apply if the divorced or legally separated spouse of the employee has been covered pursuant to RSA 415:18, VII-b, upon the occurrence of any of the following events:

(C) The 3-year anniversary of the final decree of divorce or legal separation; or

(D) Such earlier time as provided by the final decree of divorce or legal separation.

379:8 Contingent HB 921-FN; Continuation of Coverage. Amend RSA 415:18, XVI(g)(4) to read as follows:

(4) Where an individual declines the right to continue coverage pursuant to this section, waiver shall be made by an affirmative means of declination, including but not limited to written declination of continuation coverage or electronic contact to the employer or plan administrator. An individual shall have the right to revoke the notice of declaration anytime within the specified election period.

379:9 Contingent HB 921-FN; Continuation of Coverage. Amend the introductory paragraph of RSA 415:18, XVI(h) to read as follows:

(h) End of Continuation Coverage. Nothing in this paragraph shall require a carrier to continue coverage pursuant to this section beyond:

379:10 Contingent HB 921-FN; Group or Blanket Policy Provisions. RSA 415:18, VII-b is repealed and reenacted to read as follows:

VII-b. Any group or blanket accident and health insurance policy covering a resident of New Hampshire shall contain the following provisions:

(a) Upon a final decree of divorce or legal separation, if one spouse is a member of a group or blanket accident and health insurance policy, the former spouse who is a family member or eligible dependent under said policy prior to the date of the decree shall be and remain eligible for group benefits as a family member or eligible dependent under said policy, without additional premium or examination, as if said decree had not been issued. Such eligibility shall not be required if the decree expressly provides otherwise.

(b) The former spouse shall be eligible for coverage pursuant to this section through the member’s participation in a group or blanket accident and health insurance policy, while such policy remains in force or is replaced by another group or blanket policy covering the member, until the earliest of the following events occurs:

(5) Such earlier time as provided by the final decree of divorce or legal separation.

(c) Upon the occurrence of the earliest of the events set forth in subparagraph (b), other than remarriage of the former spouse, the former spouse shall have the right to continuation coverage under RSA 415:18, XVI. An insurance carrier may charge a premium for the former spouse’s continuation coverage under this subparagraph, in accordance with RSA 415:18, XVI. The former spouse shall request enrollment under RSA 415:18, XVI, in writing, within 30 days after the first occurring of the events set forth in subparagraph (b), provided that the former spouse may not request enrollment upon remarriage of the former spouse. If the first occurring event is the member’s remarriage or death, the former spouse may request enrollment under RSA 415:18, XVI, in writing, within 30 days after receiving notice of said event.

(g) Upon termination of the eligibility of a former spouse for group coverage pursuant to this section, said former spouse may apply for individual coverage or the high risk pool, whichever is applicable.

(h) Eligibility of a former spouse for group coverage pursuant to this section exists independent of any right to continuation of coverage under RSA 415:18, XVI. To the extent that there is a conflict between this paragraph and RSA 415:18, XVI with respect to eligibility for group coverage upon a final decree of nullity, divorce or legal separation, the provisions that confer greater rights on the former spouse shall apply unless the decree expressly provides otherwise.

379:11 Contingent HB 921-FN; Group Health Insurance Plans. Amend RSA 458:18-a to read as follows:

458:18-a Group Insurance Plans. Upon a decree of nullity, divorce, or legal separation, if one spouse is a member of a group health insurance plan and the employer or any other sponsor is responsible for the payment of the premium required by the insurer as the consideration for providing coverage to an ex-spouse, such premium shall be paid either by the health insurance plan member, the ex-spouse of the member, or by both the member and the ex-spouse as they shall agree or as shall be ordered in the decree of divorce by the court. The provisions of this section shall apply to dental coverage provided by such group health insurance plan and shall apply whether or not the ex-spouse is receiving child support payments. This section shall apply only to continued coverage under RSA 415:18, [~~VII(g)(1)~~] XVI or 29 U.S.C. section 1161, and shall not affect or limit any rights of the former spouse under RSA 415:18, VII-b.

379:12 Contingency. If HB 921-FN of the 2007 legislative session becomes law, sections 1 and 2 of this act shall not take effect, sections 3-4 of this act shall take effect January 1, 2008, and sections 5-11 of this act shall take effect January 1, 2008 at 12:01 a.m. If HB 921-FN of the 2007 legislative session does not become law, sections 1-4 of this act shall take effect January 1, 2008, and sections 5-11 of this act shall not take effect.

I. Sections 1-11 of this act shall take effect as provided in section 12 of this act.