In the Matter of Emily Sanborn and Timothy E. Sanborn
176 A.3d 763
N.H.2017Background
- Emily and Timothy Sanborn divorced; final decree in 2009 provided each party was responsible for their own health and dental insurance.
- Timothy appealed; mandate issued April 21, 2011. In 2013 the parties agreed to amend the decree to provide Timothy three years of continuation dental coverage retroactive to April 21, 2011, expiring April 20, 2014, while Emily remained employed with the same employer offering the plan.
- Emily’s employer (Breed’s Hill) was acquired in March 2014; her plan with Principal continued through April 30, 2014; she then moved to an Aetna plan May 1, 2014, and later changed jobs in 2015.
- Timothy later claimed he should have been notified of termination of coverage and asserted entitlement to extended continuation under RSA 415:18, XVI(c)(5) because he turned 55 during the coverage period.
- Trial court held Timothy was eligible for continuation under RSA 415:18, XVI and further held he qualified for extended coverage under XVI(c)(5); it ordered Emily to add Timothy to her plan retroactively and potentially pay unpaid dental expenses. Trial court denied Timothy attorney’s fees.
- Supreme Court reversed the order requiring additional coverage/payment (holding Timothy received the single 36‑month continuation he was entitled to) and affirmed denial of attorney’s fees.
Issues
| Issue | Plaintiff's Argument (Emily) | Defendant's Argument (Timothy) | Held |
|---|---|---|---|
| Whether coverage from the 2013 decree amendment is governed by RSA 415:18 VII‑b or XVI | The original decree expressly disclaimed spousal coverage; therefore VII‑b never arose and the 2013 amendment created XVI continuation coverage | The amendment and statutory scheme entitle him to protections/rights under VII‑b or XVI as applicable | Court: Coverage from the amendment is continuation under RSA 415:18 XVI (not VII‑b) |
| Whether Timothy is entitled to extended lifetime coverage under RSA 415:18 XVI(c)(5) because he turned 55 during the 36‑month continuation | He received the full 36‑month period already; no additional XVI(c)(5) entitlement because he lost coverage due to divorce before turning 55 | He argued turning 55 during the continuation period triggers the extended protection of XVI(c)(5) | Court: XVI(c) provides separate discrete periods; Timothy lost coverage due to divorce in 2011 when he was under 55, so he is not eligible for additional coverage under XVI(c)(5) |
| Whether Emily had duty to notify carrier which would trigger carrier notice obligations, and whether Timothy is entitled to retroactive reinstatement/expenses | Emily says any duty to notify was the carrier’s (Principal), and her employment change ended the decree’s employer‑based obligation | Timothy contends Emily (as plan administrator) should have notified carrier and thus triggered carrier notice, so he lost opportunity for further continuation | Court: Not reached as basis for relief after reversing extended‑coverage order; primary holding forecloses additional XVI(c)(5) relief |
| Whether Timothy is entitled to attorney’s fees as prevailing party | Emily: no statute or agreement entitling fees; respondent not prevailing | Timothy argued for fees | Court: Denied — Timothy is not prevailing party, so no fees awarded |
Key Cases Cited
- Zorn v. Demetri, 158 A.3d 437 (N.H.) (statutory interpretation reviewed de novo)
- Reid v. N.H. Attorney Gen., 169 A.3d 509 (N.H.) (use plain language first; legislative history only if ambiguous)
- In the Matter of Salesky & Salesky, 157 A.3d 698 (N.H.) (interpretation of court orders is a question of law)
- In the Matter of Costa & Costa, 156 A.3d 323 (N.H.) (presumption that court made findings necessary to support decree)
- Boyle v. City of Portsmouth, 154 A.3d 390 (N.H.) (construction of conjunction "and")
- In the Matter of Mason & Mason, 164 A.3d 391 (N.H.) (standards for awarding attorney’s fees)