Question for Big Blue

[A_Mommy_First]

Hi Big Blue:

blb recommended I discuss my son's insurance dilemma with you.

My ex-husband quit his job and did not maintain COBRA benefits for our son (again). I did not become aware of the same until well past the 30 day requirement (per the U.S. Department of Labor). I was unable to add him to my plan as a result.

Thankfully my son's medical needs have been minimal up to this point and open enrollment begins next month. Also, I am in the process of modifying the divorce decree to make me responsible for health care instead of my ex. That way I have better control over my son's health care.

I guess my question is if the court denies the request (which I highly doubt), is there any way I can protect my son from being uninsured as a result of my ex's job hopping in the future?

Was there something more I could have done to make sure he was added to my plan?!?

Thank you,

K

 

[OTE]

I'm not big blue but I did a lot of years of HR.

I'd suggest that you talk to your attorney. Specifically ask this question. But ask if the judge will issue an order to ex's current employer forcing them to hold his last paycheck and any other money due him if/when he leaves to pay for the COBRA. Ex will argue that there's no need for COBRA because he will enroll son in new employer's plan. Your argument is that he has a history of NOT doing that and you want to protect your son. If not, second request for court order is to notify you (on behalf of your son) of husband's departure from plan AND to allow you to enroll son in COBRA on husband's behalf. Don't think this second one flies actually but I'd ask anyway. I actually don't think that you can enroll yourself or your son in COBRA except on the occasion of your divorce. Nor do I think that the judge can order the employer to enroll your son if ex doesn't. But if you can't get the cash it's worth a shot in my humble opinion.

 

[A_Mommy_First]

OTE:

The Child Support Enforcement Agency is supposed to enforce health care orders. When the responsible party obtains a new job, the SEA is supposed to issue a National Medical Support Order and the employer is obligated to comply. If medical insurance is available and the employer refuses to enroll the dependent, the employer could be held in contempt as well.

In my case, the SEA cannot even get ahold of my ex's employer to know whether it is available or not. Letters, phone calls, etc. has been made with no response. I have requested the SEA to issue an order requiring me to maintain health insurance and a withholding order to my employer. If they had done that, the 30 day requirement would not have been an issue. Unfortunately, like everything else with the SEA, it is a long process. It was quicker for me to retain an attorney and go through court.

This not only upsets me because of my son's situation, but for all uninsured children. No child should be forced to go without insurance when it is available. Clearly not everyone finds out within the 30 day requirement. I personally did not have the money available to back track and pay for all the months my son was uninsured.

Even though I am going to solve this problem in my situation by going to court, I am anxious to find out if there are any loop holes that I am not aware of. I have tried researching this issue myself, but did not get very far.

Believe it or not, I am a legal assistant for an insurance defense firm. You would think I would have more information about insurance procedures, but I do not. I am very interested in learning!

Anyway, this time I really need to go to bed...lol.

Goodnight,

K

 

[OTE]

Well I'm happy to learn something new every day... and wonder why this isn't working for my friend in my former state...

yes, non-custodial parents get away with this every day and leave the custodial parents to deal with it.

 

[A_Mommy_First]

https://web.archive.org/web/2006061.../publication/csemployers/csemployers_resp.htm

This site may help your friend...lots of info

 

[OTE]

FYI about holding the employer responsible for health care... did you look at the last line here... employee to provide written proof of new insurance in order to not do COBRA!

interesting... but her scum claims to be self-employed now so they can't get him. knowing him it will last 6 mo and he'll get a real job... which he'll keep changing. He'll do anything to avoid the child support.. it's a game to screw her with him.. this has been going on for about 6 yrs now! The fact that his kids have actually lived in homeless shelters for months while he lives comfortably in an apt doesn't seem to bother him! BUT he visits them every 4 to 6 weeks picking them up and driving them for a weekend in Disney in Orlando- after he flies to Fla! No problem buying annual passes to Disney for 4 nor airfare, hotels and car rental in Fla.. but he can't provide health insur nor pay the minimal child support. And when he finds on the last day of his visit that he's spent all his money he buys cans of stew and feeds them that! What a prince! NOT!

 

[A_Mommy_First]

That is just disgusting. I do not comprehend how a parent could deliberately withhold from a child/children just to get back at the other parent. Unfortunately too many parents are like that. It's nice that he took the kids on a vacation, but what about the rest of the time? Ugghhhhhhh!

You know as much as I cannot stand my ex and what he is doing, it is not about me and how I feel. The differences between my ex and I are just that...between us. It is too bad more parents do not realize that.

 

[bigblueagain]

sorry but just now seeing this. And I really would not have any other answer to the question other than to suggest you do get him added to your policy. First check out if he will have a pre-existing condition declared. That could pop up as he went a period of time without coverage. Depends on your employer. Do you know if they are self insured or fully insured employer group. If self insured, ERISA does not apply and that is the law that allows companies from exempting people secondary to pre-exisiting. Also depends somewhat on the size of the company. I would also suggest really looking into what benefits your coverage provides......specifically in the mental health arena. Do they require medications be prescribed by a psychiatrist rather than just regular pediatrician? what is the total amount of outpatient visits allowed per year.......many cap the total at 20, which would be inclusive of all psychiatrist, counsellor and therapist visits? Also check with prescription card coverage as to your copays for generic, nongeneric and brand. There are usually levels. Hope this helps some. And is true, no one has to COBRA if they don't want to, even with court order. COBRA is sooo very expensive, that I imagine even if court ordred most can't afford it anyway. IS there a state health plan for underinsured children or those that don't qualify for Medicaid. These are pretty well established in most states now. Ours is called Kids First. BLUE

 

[A_Mommy_First]

Bigblue:

Thankfully, pre-exisiting conditions are not an issue in my plan...I checked that right away. There is a limit on how many therapy sessions a paricipant attends, but there are exceptions. I am not sure whether his prescription will require a psychiatrist, but I will check that right away. There is a state plan, but an income limit. I make too much for that too...they think I am rich, I guess...lol. Thankfully, my son only has 1 month to go before my plan will cover him . I can't wait! I will follow the recommendations of the many caring parents here at that point. Thank you for your input.

K