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A Message from Kimberly Clouse, Financial Expert:
I have worked in the financial services industry for
nearly a decade in many capacities, most recently as
a financial advisor for individuals. Over the course
of my career, I have had the privilege of working with
a diverse range of people, from the single mother just
starting her own business to the dot.com billionaire.
Based upon my experiences, I have learned that the same
basic principles and lessons apply to a successful and
healthy financial life, whether you're starting out
or cashing out. These guiding principles include simplicity,
a long-term perspective, and above all, knowing that
you have control of your financial destiny, and all
the information you need is well within your reach.
Healthy Choices
Insurance Coverage at Different Life Stages
“Knowing your benefit options means knowing the basics
about health care law so you can protect yourself and your
dependents. And it means finding out now about some common-sense
steps you can take to make sure you have the level of health
care coverage you need at every stage of your life.”
- Alexis M. Herman, U.S. Secretary of Labor
Marriage, parenthood, divorce, and other life changes necessitate
a review of your health benefits. You should understand the
options available, and how these changes affect your coverage
and coverage costs. Adequate health insurance is a cornerstone
of any solid financial plan, so make healthy choices. And
always notify your plan in writing about any changes in coverage.
- Marriage: Know the details of your spouse’s
health plan, including deductibles, premium costs, and what
services are covered. Compare your plan with that of your
spouse to determine which is better for you and your family.
Under the Health Insurance Portability and Accountability
Act (HIPAA), you may be entitled to add your spouse and
children to either your or your spouse’s health plan
during a special enrollment period, typically within 30
days of your marriage.
- Parenthood: Under the Newborns’ and Mothers’
Health Protection Act, health plans that offer maternity
or newborn benefits typically must provide coverage for
mothers and newborns to remain hospitalized at least 48
hours following a vaginal delivery or 96 hours following
a cesarean section. (These requirements can be reduced if
the doctor and mother agree.) Birth and adoption often activate
a certain enrollment period during which you, your spouse,
and new dependents can register in your employer’s
plan, but you must notify your plan and request enrollment
within 30 days. Your child’s enrollment will be deemed
as occurring on the date of birth, adoption, or placement
for adoption.
Most health care plans cover dependent children until they
reach 19 years of age, and if they are full-time students,
until the age of 25. When your child is no longer considered
a dependent under your health care plan, he or she may qualify
to purchase temporary extended health care coverage under
COBRA, the Consolidated Omnibus Budget Reconciliation Act.
This coverage generally is available for 36 months. Notify
your employer within 60 days after your child is no longer
deemed a dependent, at which time your employer should notify
your formerly-covered child about his or her COBRA alternatives.
- Death and Divorce: The employer must notify the
health care plan within 30 days of the employee’s death,
and in the event of divorce or legal separation, the covered
employee, spouse, or dependent children must notify the
plan within 60 days.
When an employee dies, legally separates, or divorces, the
covered spouse and dependent children may qualify to buy
short-term extended health coverage for up to 36 months.
The plan should inform the insured spouse and dependent
children of their right to purchase extended health care
coverage under COBRA.
If the spouse losing coverage has medical coverage available
through his or her employer, the spouse (and any dependents)
should evaluate whether or not they would qualify to enlist
in that plan during a special enrollment period within 30
days of the loss of coverage.
In general, COBRA coverage will cost less than the cost
of individual coverage but more than coverage under the
employer’s plan since the employer will no longer be
paying a portion of the total fee.
For more information about protecting your rights to health
care coverage, visit the Consumer Information on Health Benefits
Plans section of the Department of Labor’s Pension and
Welfare Benefits Administration (PWBA) Web
site. Or contact one of the Department’s benefit
advisors in Washington D.C. at 202-219-8776 or in the PWBA
regional office nearest you.
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This column is designed to provide accurate and authoritative
information on the subject of personal finances. It is provided with the understanding
that the Author is not engaged in rendering legal, accounting, or other professional
services by publishing this column. As each individual situation is unique,
questions relevant to personal finances and specific to the individual should
be addressed to an appropriate professional to ensure that the situation has
been evaluated carefully and appropriately. The Author specifically disclaims
any liability, loss or risk which is incurred as a consequence, directly or
indirectly, of the use and application of any of the contents of this work.
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