Employee Wants to Drop Husband from Medical Ins.

njjel

An employee recently separated from her husband. She called HR and stated she wants to drop all of his insurance coverage due to the separation. Can we do this without his written consent?

Margaret Morford

The husband will have COBRA rights when they are divorced. The divorce will be the triggering event unless your state allows for a legal separation. I'd ask the employee to get a written statement from the husband requesting that his coverage be dropped. Explain to her that it's not that you don't wish to do this for her, but federal law gives him certain rights to that coverage so you need his agreement in writing to drop his coverage. This is assuming that your plan permits dropping him outside the open enrollment period and without a triggering event.

Margaret Morford
theHRedge
615-371-8200
[email]mmorford@mleesmith.com[/email]
[url]http://www.thehredge.net[/url]

Terry

I also believe that New Jersey state laws offer some protections to the spouse against leaving him without coverage. I had a similar circumstance where the husband dropped his wife in October but divorce was not final until April. Not only did we have to get her reinstated back to October (due to court order) and get all her claims reprocessed but the employee needed to pay their portion of the premium for all those months as well. I also believe I am correct in saying that NJ does NOT recognize legal separation. PLEASE do not let her proceed unless it is with her spouse's consent, you would be saving everyone a lot of stress and avoidable headaches.

ravinsure

If the coverage is contributory, I would be concerned that you may be withholding payroll against her consent. I am also not aware of any legislation that provides an employer the right to investigate why an employee may not want dependent coverage. The termination of coverage should prompt a certificate of coverage form from the current carrier or TPA, which will hopefully make the spouse aware of the deletion. I would be sure to have the employee sign both the termination of coverage request, as well as a waiver of coverage form.

Terry

While that sounds fine in theory, the reality is that most people divorcing do not live together and most carriers will only have one address of record. What then happens when coverage is termed, the notice goes to the policy holder and the person dropped has to find out the hard way (claims denied) that they no longer have coverage. As I mentioned in my previous post, New Jersey DIVORCE laws may prohibit leaving an soon-to-be ex-spouse without coverage. Maybe the best bet is to have the employee discuss this with her divorce attorney.

Rockie

I would be very hesitant about dropping someone in the case of a separation/divorce. Divorce is the qualifying event, but in some states, legal separation is a qualifyig event. Still...I would advise this employee that in the event the judge orders her to cover this spouse, she will be responsible for going back and catching up all the back premiums. This would be much more of a burden than keeping the spouse on the plan.