Health Insurance

[DK1]

What is the name of your state (only U.S. law)? NJ

We share 50/50 parenting time of our son and have joint physical and legal custody. I'm the father, his mother is carrying our son on her health insurance through her work per a court order.

She informs me that our son's health insurance has changed.

I questioned what were the options for his insurance and she said that she chose the best option for him. She later sent me an internet link to the options and the link did not work. After that she sent a separate email explaining that her company only offers one option and asked what my company offers.

Based on our court order, we should be consulting each other on matters related to our son. The deductibles on the new plan are significantly higher than the previous plan. Do I have the right to be part of this decision since we have joint custody and equal financial responsibility for the deductibles?

 

[mistoffolees]

Yes, but it may not be a battle you want to fight.

If the court order says that she is to carry the insurance and she is doing so, you don't have much of an argument.

If you had to pay 100% of the deductibles and if she voluntarily chose a high deductible plan, you just MIGHT be able to get a change, but otherwise, she's doing what the court ordered.

Pick your battles.

 

[CJane]

If the insurance is provided through her employer, why would you think you had any say in whether or not it changes?

Employers change plans all the time - you're lucky if from one enrollment period to the next, you're enrolling in the same plan you had before. Just the way it is.

And yes, you can expect deductibles to go up as well as companies try to control costs for premiums to themselves and their employees.

 

[DK1]

I'm not saying her or I have control over her company changing providers but companies generally have multiple options (PPO, HMO, ect...) to chose from....

I was just looking for a reality check on if I was off base when I feel I should have been consulted when making this decision...

 

[cbg]

I have been administering employer sponsored group plans for over 30 years, and I have seen multiple companies that only offer one option. Granted, a large company generally offers multiple choices, but small to mid-sized companies frequently offer only once choice, or only one choice per region of the country. Unless she works for IBM or Gillette or Disney or something of that magnitude, I don't have any trouble at all believing that there is only one option.

 

[LdiJ]

I'm not saying her or I have control over her company changing providers but companies generally have multiple options (PPO, HMO, ect...) to chose from....

I was just looking for a reality check on if I was off base when I feel I should have been consulted when making this decision...

I honestly think that you are off base, particularly if mom has other children that she also covers under her family plan. If you get a say in what kind of insurance plan mom carries for your son, then that also gives you a say in the kind of insurance plan she carries for herself and anybody else in her family, and of course, you would not expect to have any say in that, would you?

 

[gr8rn]

I'm not saying her or I have control over her company changing providers but companies generally have multiple options (PPO, HMO, ect...) to chose from....

I was just looking for a reality check on if I was off base when I feel I should have been consulted when making this decision...

I have been working in the health insurance industry for over 20 years. I can say that company sponsored plans are changing drastically, partly due to the new legislation, partly because the thrust for the plans are changing to push the employee to shoulder more costs. I have never seen so much upheaval. Many companies are going for HRA's and HSA's which force the employee to be more fiscally responsible. While preventive care may be covered at 100%, other expenses are paid at a lower percentage, with the employee paying a greater portion.

The HMO and PPO are going away for many employees as an option. Don't be surprised if deductables and out of pockets go way up. I would suggest you sit down with your ex and compare plans. If you still have the PPO/HMO option, then perhaps you can work out an agreement with her to change the kids to your plan and have her pay for the expenses that are not covered (copays, prescriptions, etc.) She may have no choice in options, I would not be surprised at all.

Time to sit down like adults and try to figure out whats best for the kids, and your pocketbooks.

 

[CJane]

I work for a fairly large company, with offices spread all over the US. One plan is offered to employees. You enroll or not, that's it. In the past 10 years, I've only worked for one company that offered multiple options, and they only did so for one year before removing the HMO and the PPO and going to an HSA only plan.

 

[milspecgirl]

even if there is more than 1 option offered, mom may not be able to afford the one with the lower deductible. I'm sure since she has to pay a portion of the out of pocket cost that she wants the lowest deductible too, but it may not be financially feasible.

plus- chances are she is on a family plan or at least an employee/kids plan and you have no right to choose the plan that her or any other kids she has go on. And since she cant put 1 kid on 1 plan and every one else on a different one, I'd say you are out of line on this one.