Medical Insurance.

[SESmama]

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

I have searched and no answer was found.
No, the ex refuses to talk to me about the issue.
Yes, I have asked.
The CS order states he is to carry insurance (but could not). The original CO had me carry insurance (my choice). The PP modification is silent although, via negotiations, it was agreed that I continue to carry the insurance.

I carry insurance on our son. It is a HRA policy ($3000.00 OOP max). Ex is asking for son's SS# and BC copy. I have no issues with providing the I information EXCEPT that the policy (I believe) is actually under his fiancee. They are not yet married as far as I know.

Questions:
If they are not married and the policy is indeed under her then would it not be fraud to carry our son on her policy?

Her policy is under the Fulton County Schools. All of the policies state "Eligible Dependents Are: * Your never married dependent children who are:
(2)Stepchildren under age 19 who live with you at least 180 days per year and for whom you can provide documentation satisfactory to the Plan that they are your dependents"
- Dad has him less tha 100 overnights per year
- Would this not also constitute fraud if he were to attempt to sign up our son for this insurance?

The reason I am asking is because if he does indeed carry proper insurance then I will remove son from my policy (saving large amounts of money for me, CS notwithstanding) and keep his. However, if it is fraud and son should not be allowed I don't want to run the risk of little dude ending up without coverage.What is the name of your state (only U.S. law)?What is the name of your state (only U.S. law)?

 

[LdiJ]

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

I have searched and no answer was found.
No, the ex refuses to talk to me about the issue.
Yes, I have asked.
The CS order states he is to carry insurance (but could not). The original CO had me carry insurance (my choice). The PP modification is silent although, via negotiations, it was agreed that I continue to carry the insurance.

I carry insurance on our son. It is a HRA policy ($3000.00 OOP max). Ex is asking for son's SS# and BC copy. I have no issues with providing the I information EXCEPT that the policy (I believe) is actually under his fiancee. They are not yet married as far as I know.

Questions:
If they are not married and the policy is indeed under her then would it not be fraud to carry our son on her policy?

Her policy is under the Fulton County Schools. All of the policies state "Eligible Dependents Are: * Your never married dependent children who are:
(2)Stepchildren under age 19 who live with you at least 180 days per year and for whom you can provide documentation satisfactory to the Plan that they are your dependents"
- Dad has him less tha 100 overnights per year
- Would this not also constitute fraud if he were to attempt to sign up our son for this insurance?

The reason I am asking is because if he does indeed carry proper insurance then I will remove son from my policy (saving large amounts of money for me, CS notwithstanding) and keep his. However, if it is fraud and son should not be allowed I don't want to run the risk of little dude ending up without coverage.What is the name of your state (only U.S. law)?What is the name of your state (only U.S. law)?

Then I suggest that you keep the child insured, because it does sound like it would be fraud.

 

[cbg]

Based SOLELY on the information here, I would agree. However, I would hesitate to give a carved-in-stone answer unless I had read the ENTIRE section on dependent eligibility, and not just a portion of it.

 

[SESmama]

"Dependent
Eligible
Dependents are:
• Your legally married spouse; as defined by Georgia law.
• Your never married dependent children who are:
(1) Natural or legally adopted children under age 19, unless they are
eligible for coverage as employees. Children that are legally adopted
through the judicial courts become eligible only after they are placed in
your physical custody.
(2) Stepchildren under age 19 who live with you at least 180 days per
year and for whom you can provide documentation satisfactory to the
Plan that they are your dependents.
(3) Other children under 19 if they live with you permanently and
legally depend on you for financial support – as long as you have a court
order, judgment or other satisfactory proof from a court of competent
jurisdiction.
(4) Your natural children, legally adopted children or stepchildren
19 or older from categories 1, 2 and 3 above who are physically or
mentally disabled prior to age 26 and who depend on you for primary
support.
(5) Your natural children, legally adopted children, stepchildren or
other children age 19 to 26 from categories 1, 2 and 3 above who are
registered Full-time Students at fully accredited schools, colleges,
universities, or nurse training institutions and, if employed, who are not
eligible for a medical benefit plan from their employer. The number of
credit hours required for Full-time Student status is defined by the
school in which the child is enrolled. You have 31 days from the date of
your child’s enrollment as a full-time student to add dependent coverage
or to change your coverage tier because your child is no longer a fulltime
student.
You must also provide a completed Dependent Student Status Information
form and Full-time Student Verification from a fully accredited school,
college, university, or nurse training institution.
You will be required to provide copies of certified documents such as a
marriage license, birth certificate, adoption contract or judge signed court
order to verify your dependent relationship.
Note: Coverage will not be updated until verification is approved.
The Plan has the right to determine whether or not the
documentation satisfies Plan requirements. Coverage will be
updated from the qualifying event date or 1st day of current plan
year, whichever is later.

Who’s Not
Eligible For
Dependent
Coverage
The most common examples of persons not eligible for SHBP
dependent coverage include:
• Your former spouse
• Your fiancé
• Your parents
• Married or formerly married children
• Children age 19 or older who do not qualify as Full-time Students or
disabled dependents
• Children in military service
• Grandchildren who cannot be considered eligible dependents
• Stepchildren who do not live in your home at least 180 days per year
Anyone living in your home that is not related by marriage or birth,
unless otherwise noted."

http://dch.georgia.gov/vgn/images/portal/cit_1210/48/9/116591038UHC 2010 Choice (HMO).pdf