download - Contra Costa County Bar Association

More documents

Recommendations

Info

Domestic Partner Coverage Rights Under the California Insurance Equality Act by Ralph L. Jacobson GJEL Accident Attorneys Under California law, registered domestic partners are “two adults who have chosen to share one another’s lives in an intimate and committed relationship.” 1 The California Domestic Partner Rights and Responsibilities Act of 2003 required that registered domestic partners be provided the same rights, protections and benefits as spouses; and that they also be subject to the same responsibilities, obligations and duties under law. 2 One year later, the California Insurance Equality Act 3 (hereafter referred to as The Equality Act) was enacted to mandate that insurance policies governed by the law provided coverage for the domestic partner equal to that provided for the spouse of an insured. It states: (a) Every policy issued, amended, delivered, or renewed in this state shall provide coverage for the registered domestic partner of an insured or policyholder that is equal to, and subject to the same terms and conditions as, the coverage provided to a spouse of an insured or policyholder. A policy may not offer or provide coverage for a registered domestic partner if it is not equal to the coverage provided for the spouse of an insured or policyholder. This subdivision applies to all forms of insurance regulated by this code. (b) A policy subject to this section that is issued…shall be deemed to provide coverage for registered domestic partners that is equal to the coverage provided to a spouse of an insured or policyholder. (c) It is the intent of the Legislature that, for purposes of this section, “terms,” “conditions” and “coverage” do not include instances of differential treatment of domestic partners and spouses under federal law. The Equality Act also amended Insurance Code Section 10121.7, regarding group health insurance, to read: “A policy of group health insurance that provides hospital, medical, or surgical expense benefits shall provide equal coverage to employers or guaranteed associations, as defined in Section 10700, for the registered domestic partner of an employee, insured, or policyholder to the same extent, and subject to the same terms and conditions, as provided to a spouse of the employee, insured, or policyholder, and shall inform employers and guaranteed associations of this coverage. A policy may not offer or provide coverage for a registered domestic partner that is not equal to the coverage provided to the spouse of an employee, insured, or policyholder.” Prior law had required group health care insurance plans and policies of group disability insurance to offer coverage for the domestic partner of an employee or insured to the same extent as coverage provided to a dependent. 4 That statute was amended by the Equality Act as well. This prior definition seemed to be at odds with the statutory definition of dependent, which was: “’Dependent’ means the spouse or child of an eligible employee, subject to applicable terms of the health benefit plan covering the employee...” 5 On its face, this definition did not seem to include the domestic partner, leaving ambiguity. Prior to adoption of the Equality Act, there were also gray areas as to the contractual standard of what constituted a dependent in a health insurance contract. Most revealing in that regard is Prudential Ins. Co. of America, Inc. v. Superior Court, 6 which concerned whether or not a college student daughter of an insured was, or was not, a qualified dependent under her parents’ health insurance policy at the time she suffered catastrophic injuries. Under the policy, qualified dependent status was defined to include children of the insured over the age of 18 who were full-time students. In this case, the insured’s daughter had chosen not to enroll in school for the quarter following her freshman year due to personal problems, but she had retained the right to seek re-admission. Evidence from the school indicated that this was not an unusual circumstance; and the parents and student asserted she should be deemed a qualified 26 MARCH 2013
Elder Abuse Litigation Will & Trust Litigation • Conservatorships BARR & BARR ATTORNEYS 318-C Diablo Road • Danville, CA 94526-3443 • (925) 314-9999 Edward E. Barr (retired) Loren L. Barr* Christopher M. Moore Konstantine A. Demiris Tracey McDonald, Paralegal *Certified Specialist, Estate Planning, Trust and Probate Law, The State Bar of California Board of Legal Specialization dependent in light of her continuing relationship with her school at the time of the accident. But the appellate court, citing out-of-state cases on the same subject, held that the plain meaning of “full-time student” is “attending classes on a substantial basis.” Since the daughter had not met this requirement for the quarter in question, the court granted summary judgment in favor of the insurance company, and denied the daughter’s claim, finding that she was not a qualified dependent. Fortunately, prior to adoption of the Equality Act, there were no appellate cases which had to construe similar factual permutations of a partner’s status that might arise during a domestic partnership (part-time residency, lack of financial dependency on the other partner, etc.), in conjunction with this sort of murky notion of dependent status. The outcome would have been less than predictable, had such cases arisen. According to one commentator, these ambiguities caused real world problems for domestic partners: “Without a uniform definition [of dependency], confusion often resulted in the area of health insurance and domestic partners were routinely denied benefits and coverage, or were forced to pay higher premiums.” 7 Under the Equality Act, there is now a “bright line” test: the domestic partner is indeed entitled to equal coverage as the named insured, without condition, and without the need for interpretation of dependency status. For this reason, if nothing else, the Equality Act has served its purpose: premiums can be calculated based upon the known status of a domestic partner; and domestic partners can be assured of the right to the same insurance contract health benefits purchased by their partner, or by their employer on their behalf. A longer term question will be to what extent, over time, these health insurance rights of registered domestic partners might become subject to preemption by either law or regulation under ObamaCare. s 1 Family Code § 207(a). 2 Family Code § 207.5. 3 Ins. Code, § 381.5, et seq. 4 Cal. Health & Safety Code § 1374.58(a). 5 Ins. Code, § 10700(e). 6 Prudential Ins. Co. of America, Inc. v. Superior Court (2002) 98 Cal.App.4th 585, 600 7 Meredith A. Felde, California Insurance Equality Act: Providing Equal Insurance Coverage to Domestic Partners (2005) 36 Mc- George L. Rev. 917, 920. Ralph L. Jacobson is a founding partner of, and now of counsel to, the law firm of Gillin, Jacobson, Ellis, Larsen & Lucey in Orinda. CONTRA COSTA COUNTY BAR ASSOCIATION CONTRA COSTA LAWYER 27
Page 1 and 2: Contra Costa LAWYER Volume 26, Numb
Page 3 and 4: TED AND HIS CALIFORNIA FORMS WERE I
Page 5 and 6: 2013 BOARD OF DIRECTORS Jay Chafetz
Page 7 and 8: CCCBA - It’s Your Organization pr
Page 9 and 10: erations and those concerned with g
Page 11 and 12: The California Cliff by Mark Ericss
Page 13 and 14: ATRA also retained the 25 percent r
Page 15 and 16: Business Tax Provisions of ATRA 201
Page 17 and 18: IRS Return Preparer Regs Derailed b
Page 19 and 20: Annual Officer Installation January
Page 21 and 22: Meet Your New Commissioner: ANITA S
Page 23 and 24: Meet Your Local Judges, Family and
Page 25: RES IPSA JOKUITOR XVIII THE JOKE SP
Page 29 and 30: Unfortunately, the rate reduction e
Page 31 and 32: Win A $100 GIFT CARD! We will be se
Page 33 and 34: that can be expensive for the clien
Page 35 and 36: CALENDAR UPCOMING EVENTS | OVERVIEW
Page 37 and 38: April 25 | Employment Section The E
Page 39 and 40: Why YOU should make referrals to CC

download - Contra Costa County Bar Association

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?