Members who are divorced may or may not be able to provide health insurance coverage for dependents under PEIA. Below are the eligibility rules:

Former Spouse

If a PEIA-insured employee and his or her spouse divorce, the employee must remove the ex-spouse from coverage, even if the court orders the employee to provide medical coverage for the ex-spouse. Ex-spouses are NOT eligible dependents in the PEIA plan. To provide the coverage for an ex-spouse as ordered by the court, the employee must look to COBRA coverage or for other privately available coverage.

Dependent Child(ren)

If a PEIA policyholder and his or her spouse divorce, and the policyholder is not the custodial parent for the dependent child(ren), the employee may continue to provide medical benefits for the child(ren) through the PEIA plan. If the non- custodial parent is ordered by the court to provide medical benefits for the child(ren), the custodial parent may submit medical claims for the court-ordered dependent(s), and benefits may be paid directly to the custodial parent. Special claim forms are required. The custodial parent will also receive Explanations of Benefits (EOBs) for the CODs as claims are processed. Contact PEIA to discuss this benefit.

Go to Court-Ordered Dependent Claim Packet