Insurance Department issues clarification on SB197 and HB 790

September 25, 2007

SB197 (Divorced Spouse Bill) and HB790 (Dependent Care Expansion) questions answered by Insurance Department

Several questions arose after the legislature passed SB197 and HB790. In response, Insurance Commissioner Roger Sevigny has issued further clarification.

SB197: Five questions regarding any group or blanket accident and health policy covering New Hampshire residents were addressed.

1. Does the bill apply to a final decree of divorce that occurs before the January 1, 2008 effective date?

In short, it does not as there is no legal requirement that the policy contain this provision before January 1, 2008. Therefore, there is no right to remain on the policy in a divorce occurring before January 1, 2008.

2. Does SB197 apply to policies that are in force as of January 1, 2008, or only those that are issued and delivered on or after the effective date?

For policies issued and delivered before the January 1, 2008 effective date, but in force as of January 1, 2008, the policies would not contain the required provision allowing for continued eligibility for benefits. The legislation does not distinguish between policies in force as January 1, 2008 and those issued and delivered on or after the effective date of the legislation. Due to the absence of any limiting language in the bill, the right to continued eligibility for benefits is deemed to apply to all policies in force as of January 1, 2008, regardless of the date of issue and delivery.

3. Is the right to continued access portable and continues when the subscriber terminates coverage with one employer and obtains coverage from a new employer?

It is not portable. The right to continued eligibility continues so long as the member maintains coverage either under the same plan or under a new plan offered by his/her employer. In the event a member terminates coverage and obtains new coverage from a different employer, the former spouse has the right to obtain continuation of coverage with the original group under New Hampshire law.

4. Does SB197 apply to policies that are issued and delivered outside of New Hampshire, but cover New Hampshire Residents?

The law provides that any group or blanket accident and health insurance policy covering a New Hampshire resident shall provide a right of continued eligibility upon divorce.

5. How long is a former spouse eligible to receive continuation of coverage when coverage under the employee's plan terminates?

If coverage under the employee's plan terminates due to the remarriage of the member, the remarriage of the former spouse, the death of the member, the third year anniversary of the divorce or legal separation, or an earlier time as provided in the divorce, then the right of a former spouse who is 55 years or older when the member dies until that person becomes eligible for Medicare or another group plan. However, if the right to continuation coverage arises due to the member's termination of employment the right shall continue for a period of 18 months.

To read the entire Insurance Department release for SB197, click here.

HB790: Dependent Care Expansion. To fulfill the intent of HB790-FN and to provide subscribers with the opportunity to enroll their dependents, the department requires a carrier to implement a special open enrollment period meeting one of the two following standards.

1. The carrier shall provide notice to eligible subscribers on or before July 31, 2007 and shall hold a special open enrollment period that runs from August 1st through September 30, 2007.

2. The carrier shall provide notice to eligible subscribers of a special open enrollment period of at least 60 days and shall deliver this notice to subscribers at least 30 days prior to the start of the special enrollment period. The notice shall be sent to eligible subscribers on or before October 1, 2007, and the special open enrollment shall begin no later than November 1, 2007.

Dependents who are not enrolled during this special open enrollment shall be treated as late enrollees pursuant to RSA 420-G:8.

For a complete copy of the Insurance Department release on HB790 click here.

If you have questions regarding the impact of SB197 or HB790, please contact your NEEBCo representative at 228-1133.

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