Also known as:health insurances · medical insurance · health coverage
Written by attorneys · grounded in primary & secondary sources — see below
A contract under which an insurer agrees to pay or reimburse the insured for expenses arising from illness or injury.
Sources & Authorities
How it applies
Common Examples
6
Mandate Payment Treated As Tax
Hunter Hughes declined to purchase any health coverage for the year. The IRS collected an exaction from him along with his income tax return. The amount varied with his household income and filing status and produced substantial revenue overall. A court examined the payment's practical operation and effect rather than its statutory label and classified the exaction as a tax.
Alimony Includes Insurance Costs
After divorce proceedings, the court ordered Alexander Jones to pay Adriana Jones monthly alimony. The award included a separate amount covering the $715 cost of her COBRA health insurance through his former employer. The court examined the reasonableness of that expense on an expanded record before finalizing the order.
Select any source to read its text and confirm it supports the definition.
Cases
Statutes
Uniform Acts
Restatements
Dictionaries
Jones v. Jones2016 WL 4123920 (Del.)
Spousal Health Benefits Recognized
Emilia and Harper entered a valid same-sex marriage abroad. Titan Studios, a state-owned employer, refused to enroll Harper in its subsidized health plan because state law did not recognize the marriage. The court held that the denial violated constitutional guarantees of equal marital recognition and ordered the benefits provided.
Obergefell v. Hodges576 U.S. 644 (2015)
Premium Offer In Employment Dispute
Perich, a called teacher at a religious school, developed narcolepsy and took disability leave. The school offered to pay part of her health insurance premiums if she resigned. Perich refused and asserted her legal rights. The congregation's offer formed part of the employment relationship examined under the ministerial exception.
Hosanna-Tabor Evangelical Lutheran Church and School v. Equal Employment Opportunity Commission565 U.S. 171, 132 S. Ct. 694 (2012)
Contraceptive Coverage Mandate
Hobby Lobby Stores maintained a group health plan for employees. Federal regulations required coverage of certain contraceptives without cost sharing. The company objected on religious grounds and sought an exemption. The Court evaluated whether the mandate substantially burdened the company's exercise of religion.
Burwell v. Hobby Lobby Stores, Inc.573 U.S. 682 (2014)
State Interest In Life Preservation
Cruzan remained in a persistent vegetative state with no health insurance or state program covering her care. Missouri asserted an unqualified interest in preserving life. The Court noted that the state had no statute requiring procurement of medical care or a program to underwrite such expenses for all citizens.
Cruzan by Cruzan v. Director, Missouri Dept, of Health497 U.S. 261, 277 (1990)
Common questions
Frequently Asked
4
How does a court determine whether an exaction for failing to obtain health insurance qualifies as a tax?+
A court looks to the measure's practical operation and effect rather than its statutory label. Collection through income tax returns, variation with household income and filing status, and capacity to raise substantial revenue support classification as a tax.
May health insurance premiums be included in an alimony award?+
Yes. Courts may award a separate monthly amount for the reasonable cost of COBRA coverage through a former spouse's employer when the recipient lacks independent means to pay.
Does denial of spousal health benefits to a same-sex couple violate the Constitution?+
Yes. The Constitution requires equal recognition of valid marriages, including access to employment-related benefits such as subsidized health coverage, regardless of the sex of the spouses.
Can a religious employer condition health insurance payments on resignation during a disability dispute?+
Such an offer may form part of the employment relationship examined under the ministerial exception, but the exception ultimately bars certain employment claims by ministers.
576 U.S. 644 (2015)Legislation and Regulation
…birth and death certificates; professional ethics rules; campaign finance restrictions; workers’ compensation benefits; health insurance; and child custody, support, and visitation rules. See Brief for United States as Amicus Curiae 6–9; Brief for American Bar Association as Amicus Curiae 8–29. Valid marriage under state law…