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Click ‘Get Form’ to open the Former Spouse Coverage document in the editor.
In Section I, mark the box indicating your choice of coverage: either 'Former Spouse' or 'Former Spouse and Child(ren)'. If selecting child coverage, ensure you list eligible children in Item 11.
Proceed to Section II. Indicate your current marital status by checking 'Yes' or 'No'. If married, provide details about your current spouse including their name, SSN, and address.
Complete any necessary legal basis for your election in Items 4, 5, and 6. Attach required documentation such as a divorce decree if applicable.
In Section III, fill out the member and former spouse information. Ensure both parties sign and date the form before submission.

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How long can my ex-wife stay on my insurance?

The Plans Working Spouse Rule states that, if your spouse is working for an employer who offers a health plan, the Plan requires them to enroll in that employer-sponsored coverage to be eligible for Plan coverage. Your spouse must confirm whether they have access to and are enrolled in their employers health plan. Working Spouse Rule - SAG-AFTRA Plans SAG-AFTRA Plans health wsr SAG-AFTRA Plans health wsr

Can a man keep his ex-wife on his health insurance?

When a couple decides to divorce, they both stay insured on the existing plan during the process. But once the divorce is final, the non-policyholder is no longer considered a family member and isnt covered on the plan. That spouse will have to find new insurance coverage and pay their own premium. Health insurance after a divorce | UnitedHealthcare United Healthcare Benefits coverage United Healthcare Benefits coverage

How long can I keep my ex-spouse on my health insurance?

You can keep COBRA coverage for up to 36 months after divorce. However, its important to note that the full cost of the insurance falls on you. Youll be paying not only the portion your spouses employer used to cover but also an additional administrative fee, which can add up quickly.

What is considered a former spouse?

You can lose your TRICARE eligibility under either scenario if you: Remarry, even if the remarriage ends in death or divorce (unless you gain eligibility under your new spouse) Purchase and are covered by an employer-sponsored health plan. Were the former spouse of a NATO or Partners for Peace nation member.