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Health Benefits Advisor

No Current Group Health Plan Coverage through Former Spouse

Your former spouse's employer, employee organization (such as a union), or both, are not required to offer you and your dependent children the opportunity to elect COBRA continuation coverage if your former spouse's employer, employee organization, or both, no longer sponsor a group health plan. Under special rules, if your former employer was acquired by another business, that provides group health benefits, the acquiring business may have successor liability and a duty to offer you COBRA continuation coverage. See IRS regulations for more information.

You should, however, know that there are other options available that may assist you and your family in obtaining health coverage. For example, you and your dependent children may have special enrollment rights in a plan sponsored by your employer or in another group health plan. You may also be eligible for Medicaid, Medicare, CHIP (Children's Health Insurance Program) or other health coverage.

In choosing among the options available to you, you should review the SPD (Summary Plan Description) for each available group health plan to determine which plan best meets your needs. You should also review and compare the information on the other coverages for which you are eligible. In making your decision, you may want to consider such things as:

  1. Any waiting period (or affiliation period) imposed under the plans;
  2. Types of benefits offered (Is dependent coverage available? Do the benefits cover your family's medical needs?);
  3. Cost of coverage (premiums, co-payments and deductibles for prescription drugs and doctor visits);
  4. Limitations on coverage; and
  5. Any exclusions from coverage (treatments, procedures, conditions or prescription drugs).