MA Mandate -- Continuation of Coverage for Former Spouse

[rocknrolls2]

An employer has a fully insured medical plan issued in New York which covers employees in all 50 states and US territories. MA has a mandate providing continuation coverage for a former spouse. The statute, found at Chapter 175, Section 110I (a) specifically provides, "The provisions of this section shall apply to any policy issued or renewed within or without the commonwealth and which covers residents of the commonwealth." Does the mandate apply to a contract issued in NYS which covers MA residents?

[Peter Gulia]

Your query doesn’t say whether the covered employee resides in Massachusetts.

In Foster v. Group Health Inc. (and Empire Blue Cross Blue Shield), 444 Mass. 668, 830 N.E.2d 1061, 2005 Mass. LEXIS 378 (July 15, 2005), Massachusetts’ Supreme Judicial Court interpreted Mass. Gen. Laws chapter 175 section 110I(a) to not provide its continuation coverage to a former spouse because the employee resided in New York.

Further, even if the employee resides in Massachusetts, it’s unclear whether this Massachusetts statute applies to an insurance contract if the contract is governed by New York law and was issued by an insurer that had and has no contact with Massachusetts other than the residence of the contract holder’s Massachusetts-residing participants. In those circumstances, an intelligent lawyer could present a range of constitutional-law and choice-of-law arguments for or against the application of the Massachusetts statute.

Who’s your client; the employee or the former spouse? If your client has real money at stake, he or she might invest in some lawyering.

If your client is the employer, does it have a reason to care what the insurer decides?