Massachusetts General Laws
Chapter 176g - Health Maintenance Organizations
Section 5a - Divorced or Separated Spouses; Coverage

Section 5A. (a) In the event of the granting of a judgment absolute of divorce or of separate support to which a member of a group health maintenance contract is a party, the person who was the spouse of said member prior to the issuance of such judgment shall be and remain eligible for benefits under said contract, whether or not said judgment was entered prior to the effective date of said contract, without additional premium or examination therefor, as if said judgment had not been entered; provided, however, that such eligibility shall not be required if said judgment so provides. Such eligibility shall continue through the member's participation in the contract until the remarriage of either the member or such spouse, or until such time as provided by said judgment, whichever is earlier.
(b) In the event of the remarriage of the member referred to in paragraph (a), the former spouse thereafter shall have the right, if so provided in said judgment, to continue to receive benefits as are available to the member, by means of the addition of a rider to the family contract or the issuance of an individual contract, either of which may be at additional premium rates determined by the commissioner of insurance to be just and reasonable in accordance with the additional insuring risks involved.
(c) The name, address, and policy number of a person eligible for health insurance coverage pursuant to paragraph (a) or (b), if available, shall be forwarded by such health maintenance organization to the department of public welfare within thirty days of the date when coverage of said person under said paragraph (a) or (b) is commenced.
(d) Notice of cancellation of coverage of the divorced or separated spouse of a member shall be mailed to such divorced or separated spouse at such person's last known address, together with notice of the right to reinstate coverage retroactively to the date of cancellation.
(e) Claims paid on behalf of a divorced or separated spouse or on behalf of a dependent who is not residing with the member shall be paid to the physician, hospital or other provider of covered services or to the person on whose behalf such services were performed, unless the person is a minor child. In the event the person on whose behalf such services were performed is a minor, payment shall be made to the physician, hospital or other provider of such services or to the parent or custodian with whom the child resides.

Structure Massachusetts General Laws

Massachusetts General Laws

Part I - Administration of the Government

Title XXII - Corporations

Chapter 176g - Health Maintenance Organizations

Section 1 - Definitions

Section 2 - Application of Laws

Section 3 - Organization; Accounting; Contracts

Section 4 - Required Coverage for Certain Conditions and Groups

Section 4a - Employees Terminated Due to Plant Closings; Coverage

Section 4b - Confidentiality of Information; Mental or Nervous Condition; Exceptions

Section 4c - Home Care Benefits

Section 4d - Nonprescription Enteral Formulas for Home Use

Section 4e - Off-Label Drug Use; Cancer Treatment

Section 4f - Group Health Maintenance Contracts; Coverage for Bone Marrow Transplants

Section 4g - Off-Label Use of Prescription Drugs for HIV/AIDS Treatment

Section 4h - Items Medically Necessary for Diagnosis and Treatment of Diabetes

Section 4i - Prenatal, Childbirth and Postpartum Care Benefits; Minimum Coverage for In-Patient Care

Section 4j - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment

Section 4k - Newborn Hearing Screening Tests

Section 4l - Coverage for Hospice Services

Section 4m - Mental Health Benefits; Biologically-Based Mental Disorders; Rape-Related Mental Disorders; Non-Biologically-Based Mental Disorders of Children and Adolescents Under Age 19

Section 4n - Coverage for Speech, Hearing and Language Disorders; Hearing AIDS

Section 4o - Outpatient Services; Hormone Replacement Therapy for Peri and Post Menopausal Women; Contraceptive Services; Approved Prescription Contraceptive Drugs or Devices; Exception

Section 4p - Patient Care Services Provided Pursuant to Qualified Clinical Trials

Section 4q - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing

Section 4s - Coverage for Prosthetic Devices and Repairs

Section 4t - Coverage for Eligible Dependents Under 26 Years of Age

Section 4u - Coverage for Medically Necessary Hypodermic Syringes or Needles

Section 4v - Coverage for Diagnosis and Treatment of Autism Spectrum Disorder

Section 4w - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate

Section 4x - Coverage for Orally Administered Anticancer Medications

Section 4y - Coverage for Abuse Deterrent Opioid Drug Products

Section 4z - Preauthorization for Substance Abuse Treatment Not to Be Required

Section 4aa - Coverage for Medically Necessary Acute Treatment and Clinical Stabilization Services

Section 4bb - Coverage for Long-Term Antibiotic Therapy for Patients With Lyme Disease

Section 4cc - Coverage for Medical or Drug Treatments to Correct or Repair Disturbances of Body Composition Caused by HIV Associated Lipodystrophy Syndrome

Section 4dd - Filling of Remaining Portion of Prescription for Covered Drug That Is a Narcotic Substance Earlier Filled in Lesser Quantity

Section 4ee - Pain Management Access Plans

Section 4ff - Coverage for Tobacco Use Cessation Counseling and Tobacco Cessation Products

Section 4hh - Coverage for Long-Term Antibiotic Therapy for Lyme Disease; Experimental Drugs

Section 4ii - Coverage for Prescription Eye Drops

Section 4gg - Coverage for Treatment of Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections and Pediatric Acute-Onset Neuropsychiatric Syndrome

Section 5 - Emergency Services Provided to Members for Emergency Medical Conditions

Section 5a - Divorced or Separated Spouses; Coverage

Section 6 - Contracts

Section 6a - Group Health Maintenance Contracts; Contribution Percentages

Section 6b - Retroactive Claims Denials for Behavioral Health Services

Section 8 - Public Dissemination of Deceptive or Misleading Materials

Section 9 - Trade Regulation Practices; Application of Law

Section 10 - Reports; Audits, Examinations or Inspections; Confidentiality and Privilege

Section 10a - Applicability of Chapter 176v to Health Maintenance Organizations Governed by This Chapter

Section 10b - Applicability of Chapter 176w to Health Maintenance Organizations Governed by This Chapter

Section 11 - Contracts With Group Insurance Commission or Local Governments

Section 11a - Alternative Dental Coverage Option

Section 12 - Health Regulations Not Limited

Section 13 - Name Restriction

Section 14 - Licensure Applicants; Documents Required; Approval by Commissioner

Section 15 - Bond; Waiver

Section 16 - Contracts, Rates, Evidence of Coverage; Disapproval of Commissioner

Section 16a - Disapproval of Certain Health Maintenance Contracts Based on High Deductibles

Section 16b - Disapproval of Certain Health Maintenance Contracts for Coverage of Young Adults

Section 17 - Rules and Regulations; Standardized Claim Form

Section 17a - Open Enrollment for Nongroup Medicare Beneficiaries; Period, Notice of Termination

Section 19 - Discrimination Against Abuse Victims in Terms of Health Maintenance Contract

Section 20 - Insolvent Health Maintenance Organization; Administrative Supervision, Rehabilitation or Liquidation; Priority of Claims

Section 20a - Administrative Supervision, Rehabilitation or Liquidation of Health Maintenance Organizations; Revocation or Suspension of License

Section 21 - Participating Provider; Contracts With Health Maintenance Organizations; Hold Harmless Clause; Limitation on Collection Actions

Section 22 - Health Care Providers; Liability of Member of Health Maintenance Organization; Limitation on Collection of Amounts Owed

Section 23 - Insolvency of Health Maintenance Organization; Replacement Coverage

Section 24 - Health Maintenance Contracts; Genetic Tests; Discrimination Based on Genetic Information

Section 25 - Net Worth of Health Maintenance Organization

Section 26 - Deposit Maintained With Trustee Acceptable to Commissioner

Section 27 - Merger or Acquisition of Control

Section 28 - Registration With Commissioner

Section 29 - Violations of Secs. 27 to 29; Application for Order Enjoining Violations of Secs. 27 to 29; Penalties

Section 30 - Statement for Individuals Provided With Creditable Coverage; Reporting

Section 31 - Attribution of Members to a Primary Care Provider

Section 32 - Disclosure of Patient-Level Data and Contracted Prices of Individual Health Care Services by Carriers to Providers

Section 33 - Coverage for Health Care Services Delivered via Telehealth by a Contracted Health Care Provider