Introduced by Senator Ayer of Addison District and Senator Giard of Addison District
Subject: Insurance; health; divorce
Statement of purpose: This bill proposes to allow continuation of group coverage at no additional premium cost for the spouse of an employee following divorce or separation, until the spouse remarries, and then to allow continuation through a rider to the group policy.
AN ACT RELATING TO CONTINUATION OF GROUP COVERAGE FOLLOWING DIVORCE WITHOUT PREMIUM INCREASE
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1. 8 V.S.A. § 4090b(b) is amended to read:
(b) Contributions shall be due on a monthly basis in advance to the insurer or the insurer’s agent, and shall not be more than the group rate for the insurance being continued under the group policy on the due date of each payment. In the case of coverage for any individual whose insurance under the group policy would terminate because of divorce or legal separation from the covered employee, the former spouse of the covered employee shall remain eligible under the group policy. The premium shall be computed to ensure that the total premium shall be no more than the premium that would be due if not for the divorce or separation.
Sec. 2. 8 V.S.A. § 4090c is amended to read:
§ 4090c. TERMINATION OF COVERAGE
Continuation of insurance under the group policy shall terminate upon the occurrence of any of the following:
(1) the date six months after the date that insurance under the policy would have terminated due to the death or loss of employment of the employee or member, the divorce or legal separation of the covered employee from the employee’s spouse, unless there is a court order providing for the continued eligibility of the employee’s spouse for the group coverage, or a dependent child ceasing to be a dependent child under the generally applicable requirements of the policy of the employee or member;
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(4) the date on which the group policy is terminated or, in the case of an employee, the date the decedent’s or terminated employee’s employer terminates participation under the group policy. If such coverage is replaced by similar coverage under another group policy:
(A) the person shall have the right to become covered under that replacement policy, for the balance of the period that he or she would have remained covered under the prior group policy;
(B) the minimum level of benefits to be provided by the replacement policy shall be the applicable level of benefits of the prior group policy reduced by any benefits payable under that prior group policy;
(C) the prior group policy shall continue to provide benefits to the extent of its accrued liabilities and extensions of benefits as if the replacement has not occurred;
(5) the remarriage of the former spouse of the covered employee, in the case of coverage for any person whose insurance under the group policy is based on the former marriage to the covered employee. In the event of remarriage, the former spouse shall have the right to continue to receive benefits as are available to the covered employee by means of a rider to the family plan or the issuance of an individual plan, either of which may be at additional premium rates as approved pursuant to section 4062 of this title.
The Vermont General Assembly
115 State Street