56-7-2366 - Notice of termination of coverage for spouses and former spouses.

56-7-2366. Notice of termination of coverage for spouses and former spouses.

(a)  Every insured or policy holder of a group policy of accident and sickness insurance offered for sale in this state, that provides coverage for hospital or medical expenses that also provides coverage to the spouse of the insured, shall provide at least thirty (30) days' prior notice of the termination of coverage to the covered spouse as a result of a divorce, a legal separation, or other separation. The notice shall be written, filed with the court that is hearing the divorce or legal separation prior to or at the final hearing, and served upon the spouse as provided by Tennessee Rules of Civil Procedure. If no divorce, legal separation or similar legal proceeding is pending, then the notice shall be transmitted by certified mail, return receipt requested, to the last known address of the spouse.

(b)  (1)  The notice shall advise the spouse who is to be terminated that, when the divorce is final, the spouse shall not be eligible for continued coverage under the policy. The notice shall also advise the spouse of the availability of the COBRA continuation provision and of the procedures for applying for COBRA coverage, including identifying who should be contacted to obtain coverage. The notice shall indicate that the spouse who is to be terminated will be without health insurance coverage from the insured's policy and that the spouse must obtain coverage under COBRA continuation, or a separate source of insurance, if the spouse wishes to retain health insurance coverage.

     (2)  For the purposes of this subsection (b), “COBRA continuation provision” means any of the following:

          (A)  Section 4980B of the Internal Revenue Code of 1986, codified as 26 U.S.C. § 4980B, other than subdivision (f)(1), insofar as it relates to pediatric vaccines;

          (B)  The Employee Retirement Income Security Act (ERISA), Part 6 of Subtitle B of Title I, compiled in 29 U.S.C. § 1161 et seq., other than § 609, codified as 29 U.S.C. § 1169; or

          (C)  Title XXII of the Public Health Service Act, compiled in 42 U.S.C. § 300bb-1 et seq.

(c)  As an employer updates the plan summary, in the course of business, for any group policy of accident and sickness insurance that it may offer to its employees, the employer shall include a notice of the provisions of this section in the summary.

(d)  The attorney for the insured in any action for divorce shall advise the insured or policy holder of the obligation imposed by this section.

(e)  The administrative office of the courts shall develop a model notice to reflect the provisions of this section.

[Acts 2006, ch. 764, § 1; 2008, ch. 868, § 5.]