Health Insurance Dependent Question

Question

Hoping someone can help who is in Human Resources or knowledgable with health insurance plans through employers.....Can someone take a dependant off thier health insurance coverage when it is NOT open enrollment or when there's NOT a life qualifying event that has taken place, ie. death, divorce, birth, age for 18 , etc? My husband's ex wife has thier daughter on her husband's health insurance plan (thier daughter lives with us) and my husband's ex wife informed him she's taking the daughter off the insurance plan so we have to pay for her to get insurance out of our pocket. There's really no reason for her to take her daughter off the insurance plan other than to do it out of spite, because they do not have to pay extra for her and there's nothing out of it for them to keep her enrolled for another 10 months (she's 17). We've contacted the FOC and they won't return our calls and a letter has been written with no correspondence back. The current order for health insurance for my step daughter is that at least one of them has to have insurance on her, as long as one of them has insurance, the court doesn't care, but the referee verbally told both my husband and his ex wife that who ever has insurance on her now (at the tiem the order was written) should continue to keep my step daughter on their plan, which would be my husband's ex wife, but she did not write the statement in the order. Kind of vague compared to the old order, the order was recently modified after the ex wife kicked my step daughter out of her home and we got custody of her, the roles have turned because my husband used to pay $225 a week for child support for the last 16 years and on top of that, always kept insurance for my daughter out of his pocket through his employer, but now he's self employed and we really dont' want to pay for insurance for my step daughter if she can get it for free and after my husband has always been so diligent on taking care of her all these years, and now that we have custody of her, the mom is doing absolutely nothing, even after gettign help and support from my husband for so long. When my husband became self employed, he told his ex wife that he didnt' have insurance for my step daughter and she said that it was ok because she would put her on her husband's health insurance plan during open enrollment in January, which was January 2008. I do knwo that open enrollment is only in January for the husband's employer becuase I have a friend that works there and my husband contacted the insurance company to ask, but they woudln't give any other information.

Answer 1

OK,  the employee CANNOT make changes to their plan, outside of a life event, or open enrollment. HOWEVER.  These days, many insurance companies are auditing the employers, and have changed the definition of "dependent" to include, that the child must be a dependent on the employee's TAX RETURN.  Even a court order stating a particular parent must carry health insurance, can't require an insurance company to keep a non-dependent (according to THEIR definition) on their plan.

So.  It's POSSIBLE that their insurer, is taking the girl off, and mom is trying to make it sound like it's her doing it.  OR, it's possible that mom is bluffing.

Either way, you really need to get something IN WRITING, to verify if they still have the girl covered.  Calling the insurance company, well, it can take them a couple months for their records to be updated, and meanwhile, you can be accruing charges.

Answer 2

usually open enrollment for any employer is only once a year and could be within any month. Since they have taken her off the insurance then she won't be able to be added again until open enrollment.

Until this is all straightened out - I would get your daughter her own individual policy - pay the least amount monthly if that works for your family- if your daughter is sick alot then you may have to pay more. Get together all of your information and take that ex-wife back to court asap!!  

Answer 3

No, unless they lie and say she has coverage elsewhere (or something along those lines) they can't take her off midstream.

Answer 4

I would not gamble on health Insurance.  Get your stepdaughter covered then apply to family court for reimbursement of the premiums by the ex wife.