Being dropped from Insurance

[Tink11464]

What is the name of your state (only U.S. law)? PA
I'm not sure if this is under the right heading, if not - I apologize. Here is my issue: Both my daughter and I are on my husband's insurance plan at his place of employment. he has been there 7 years (all the while we have been on this plan). Prior to that I worked for a real estate company and he had his own business (so he was on my plan). The real estate office closed and he started working for this large company, so we took the insurance with his company. Within the last 2 years my health has declined (I am being treated for Rheumatoid arthritis, Psoraitis arthritis, sleep apnea and hypothyroidism).

Last week we received a request from Ceridian who is doing an insurance audit for the company. They requested our daughter's birth certificate (I have it - she was born in 2001), as well as our marriage license. I called to explain to them that we don't have a marriage license - we have been common law since 1998 (and together since 1993). They said since PA does not recognize common law - they cannot - therefore they will be dropping me from the insurance. I tried explaining to them that common law AFTER 1/1/2005 is not recognized - - before then it is. I sent them documentation showing this. I also told them we file taxes together, my license, social security card, our lease, etc... is all with his last name. Our daughter was born in 2001 to MARRIED parents.

What recourse do I have against them dropping me?

 

[Beth3]

None.

It doesn't matter whether you reside in a State which recognizes common law marriages. If the insurance company policy defines eligible dependents as a lawfully married spouse (as the great majority do), then that's just the way it is.

A few employers' insurance plans now include "domestic partners" (which is what you are in the eyes of the insurance carrier) but if your husband's carrier doesn't include that as an eligible dependent, then you're out of luck. The solution is for you and your husband to get married.

 

[Tink11464]

Beth3 Thank you for responding. But legally - - PA recognizes common law marriages that were established prior to 2005. This makes no sense. We are legally married when it comes to paying taxes, we are liable for one anothers bills, etc... How can we be legal one minute and where it's convenient for a company we aren't (of course - that's only AFTER I need certain medical treatments)?

 

[swalsh411]

Because those are there rules and there is no law which says they must follow your State's definition or recongnize common law marriage.

It's not a matter of "convenience". They make money by selling insurance policies. They would rather have you as a customer than not.

This audit is for the benefit of your husband's employer not the insurance company.

 

[Mass_Shyster]

What recourse do I have against them dropping me?

The easiest and least expensive solution is to get married and send them a copy of your license.

Otherwise, I suggest you locate an attorney familiar with health insurance benefits and find out if you have a valid claim for benefits.

 

[Tink11464]

Thank you Stevef - - it's a shame that someone has to get a piece of paper to prove something that is "legal" even without it. So may people have that piece of paper and it's meaningless to them with it. My "marriage" without that piece of paper has outlasted so many that have it!!! My brother has had 4 pieces of paper in the 20 years that we haven't had ONE. But thank you again everyone for your advice!!

 

[Zigner]

Thank you Stevef - - it's a shame that someone has to get a piece of paper to prove something that is "legal" even without it. So may people have that piece of paper and it's meaningless to them with it. My "marriage" without that piece of paper has outlasted so many that have it!!! My brother has had 4 pieces of paper in the 20 years that we haven't had ONE. But thank you again everyone for your advice!!

Darn that "piece of paper"!


ETA: If your marriage is so strong, then it should definitely survive after you obtain the piece of paper, right?

 

[Beth3]

PA recognizes common law marriages that were established prior to 2005. Just because the State recognizes common law marriages does not require an insurance carrier to do so. (And if you do a little research on what legal recognition/rights you have in your State as a common law law spouse, you'll find them very limited.)

If you want all the legal rights that married couples have, then you and your husband need to get married. The insurance carrier would never have accepted you as a legal dependent of your husband's had they know you weren't married. He's lucky the carrier/his employer aren't coming after the two of you for repayment of benefits and perhaps even fraud.

 

[Tink11464]

"The insurance carrier would never have accepted you as a legal dependent of your husband's had they know you weren't married. He's lucky the carrier/his employer aren't coming after the two of you for repayment of benefits and perhaps even fraud."

Beth3 - - we are not commiting fraud - we are married, have been married, why would he say we weren't married? We have been married when we sign our taxes, we were married when we had our daughter (3 years after 1998), we are married in the eyes of our family and friends (one being a Judge who also states we are married and happens to be the Godfather to our daughter). There is no fraud of any kind. When my husband was hired he checked married, when I was hired at my job i checked married - my drivers license and social security cards have his name - which are both issued by the state.

 

[Tink11464]

"Does Pennsylvania have common-law marriage?

Yes. In Pennsylvania, common law marriages that were created before January 1, 2005 are recognized. If you met Pennsylvania's criteria for common law marriage before January 1, 2005, then you are legally married and you will be treated as a married couple for legal purposes, including the requirement that you get a legal divorce in order to end your relationship. In order to have a valid common law marriage, a couple must have intended to be married, must have lived together for a significant period of time, and must have held themselves out as a married couple."

This is only one quote off of heaven knows how many sites that have questions in regards to common law. Why would we be considered not married, much less commiting fraud if this is what we knew back in the 90's and ever since? We have lived as a married couple for all of these years (with what we were told had all the same legal rights as one with a license). Thanks - lisa

 

[Beth3]

Beth3 - - we are not commiting fraud - we are married, have been married, why would he say we weren't married? We have been married when we sign our taxes, we were married when we had our daughter (3 years after 1998), we are married in the eyes of our family and friends (one being a Judge who also states we are married and happens to be the Godfather to our daughter). There is no fraud of any kind. When my husband was hired he checked married, when I was hired at my job i checked married - my drivers license and social security cards have his name - which are both issued by the state.

You're not getting it. Under the terms of your husband's insurance plan, you are not a legal dependent. Therefore you have not been entitled to be on the plan for all these years and the premiums paid by his employer and the benefits paid for your medical bills by their insurance carrier are not costs they were obligated to incur on your behalf.

If they wanted to, they could indeed come after you and your husband for fraud. Just because you, your family and your friends consider the two of you to be married doesn't mean squat legally speaking.

I understand there was no intent to defraud but the insurance carrier doesn't give a hoot about that. What they care about is that they're out tens of thousands of dollars paid for your medical bills that they weren't obigated to pay. Your husband was responsible for understanding how "eligible dependent" was defined in the insurance plan.

 

[Tink11464]

Beth3 - - got it - - thank you

 

[Zigner]

Beth3 - - we are not commiting fraud - we are married, have been married, why would he say we weren't married? We have been married when we sign our taxes, we were married when we had our daughter (3 years after 1998), we are married in the eyes of our family and friends (one being a Judge who also states we are married and happens to be the Godfather to our daughter). There is no fraud of any kind. When my husband was hired he checked married, when I was hired at my job i checked married - my drivers license and social security cards have his name - which are both issued by the state.

You're not getting it. Under the terms of your husband's insurance plan, you are not a legal dependent. Therefore you have not been entitled to be on the plan for all these years and the premiums paid by his employer and the benefits paid for your medical bills by their insurance carrier are not costs they were obligated to incur on your behalf.

If they wanted to, they could indeed come after you and your husband for fraud. Just because you, your family and your friends consider the two of you to be married doesn't mean squat legally speaking.

I understand there was no intent to defraud but the insurance carrier doesn't give a hoot about that. What they care about is that they're out tens of thousands of dollars paid for your medical bills that they weren't obigated to pay. Your husband was responsible for understanding how "eligible dependent" was defined in the insurance plan.

Beth, the OP feels that they ARE "legally" married per the laws of the state in which she resides. I believe they may very well have been. My earlier response was based on my contempt for people who think that it's just a piece of paper. But, realistically, if they are considered married by the state of PA, and they reside in PA, then there is no fraud involved. The insurance company is wrong.

 

[Tink11464]

Zigner - - that's truly how we feel, we are and have been married - in the eyes of PA law (since 1998 and for years after). We have been together since 1993. We have lived all of these years as Mr. and Mrs. We have never thought otherwise. I am so upset by this.

 

[Zigner]

Zigner - - that's truly how we feel, we are and have been married - in the eyes of PA law (since 1998 and for years after). We have been together since 1993. We have lived all of these years as Mr. and Mrs. We have never thought otherwise. I am so upset by this.

Go to your local justice of the peace and get hitched