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Form #940Additional COBRA Clauses
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Additional COBRA
clauses.
When drafting separation agreements, you may want to
include one of these four COBRA health insurance clauses:
I.
COBRA insurance coverage shall be provided for the
_________[wife or husband] at the expense of the _________[husband or
wife] for a period not to exceed three years, the remarriage of the
_________[wife or husband], or the _________[wife or husband]'s
obtaining medical insurance, comparable in nature to the existing insurance, at
no cost to _________[husband or wife] through _________[wife or
husband]'s employment, whichever occurs first. This COBRA provision shall
not be construed as maintenance and shall have no tax consequences.
II.
The _________[husband or wife] shall pay an
additional amount to the _________[husband or wife] as maintenance for
_________[husband or wife]'s support, but specifically designated as a
contribution toward the _________[husband or wife]'s continuing health
insurance coverage under COBRA, in an equal amount to 50 percent of the cost of
that continued coverage for a period of three years after entry of the
judgment. It is anticipated that this amount will be approximately $_____
weekly to equal exactly half of the _________[husband or wife]'s cost
for continuing health insurance coverage under COBRA through the _________[husband
or wife]'s employer. These payments will continue for a maximum of three
years, shall not be modifiable for any reason whatsoever except to correspond
to the exact amount of 50 percent of the COBRA premium, and shall terminate
prior to the expiration of three years upon the death or remarriage of the
_________[husband or wife], or if the _________[husband or wife]
becomes employed and has health insurance benefits available to _________[him
or her] through that employment, whichever occurs first. It is the intent
of the parties that these payments, because they are maintenance for the
support of the _________[husband or wife], shall be taxable to the
_________[husband or wife] and deductible from the _________[husband
or wife]'s income.
III.
The _________[husband or wife] shall maintain
health care insurance benefits for the _________[husband or wife], at
_________[husband or wife]'s expense, for the maximum three-year period
allowed under COBRA. That obligation, however, will terminate if the _________[husband
or wife] becomes employed on a full-time basis prior to the expiration of
three years and is offered health insurance as a benefit of that employment.
IV.
The _________[husband or wife] shall secure
group medical insurance coverage for the _________[husband or wife],
identical to that covering _________[husband or wife] during the
marriage through _________[husband or wife]'s employer, under the
provisions of COBRA for a period of _________[time period] from the date
of entry of this judgment or until the _________[husband or wife]
becomes eligible for group medical insurance coverage through the _________[husband
or wife]'s own employer, whichever occurs first. The _________[husband
or wife] shall make all premium payments required to maintain the COBRA
benefit in full force and effect.
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These forms are provided to assist business owners and others in understanding important
points to consider in different transactions. They are offered with the understanding
that no legal advice, accounting, or other professional service is being offered
by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com
is not engaged in recommending or referring members on the site or making claims
about the competence, character or qualifications of its participating members.
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