Court ordered for child to be off ins. Ins. WON'T DO IT!

[vibbershniven]

What is the name of your state? MI

In December I filed for divorce and was told that it would be court ordered for me to cover my daughter's health insurance. I voluntarily placed her on my policy for over $500 a month out of pocket.

Then we had a temp. custody hearing on March 7, 2003. It was stated then, that I would no longer have to supply health insurance for my daughter. This was placed in the stipulation/order. I faxed this order to the insurance company; however, they still won't remove her from the policy! At first it was they can't cancel a policy in the middle of a month, so they continued to take out the money for another two weeks. Then April arrives and it's they can't cancel a policy in a middle of a period....continued to take the money. Now I'm being told that they will not take her off the policy and continue to charge me for it because they were not personally court ordered to remove her from the policy. I have a court order that I don't have to supply health insurance for her. Why won't the insurance company remove her? How do I get them personally court ordered? My lawyer is being no help, hasn't even bothered answering my calls, please help...with child support and health insurance deductions they are taking over 60% of my income! Why isn't the court order stating I don't have to cover her enough?

As it stands my wife doesn't use my insurance because she covers her on Medicaid. So in the end I'm paying over $500 a month for insurance for her alone and paying around $400 in child support of which goes to pay Medicaid back for them covering her. So none of the money goes to helping my daughter at all!!!

 

[cbg]

Critical question: When your portion of the insurance premium is deducted from your paycheck, is it done pre-tax or post-tax? The answer to this question will make a great deal of difference to the answer.

 

[vibbershniven]

I believe it's post tax. Only my child support is taken out before I pay taxes. This makes a difference?

I wrote and faxed a letter to the insurance company last night. That was after I read the Friend of the Court handbook and found out they don't court order the insurance company directly. That is what the ins. comp. said...that if it was actually court ordered they would have been court ordered personally. I also found out from them that if the change was requested within the first thirty days of the policy, there wouldn't have been a problem making the change. The problem being that I did request it two weeks after the policy started, the gentleman I was speaking to said the wrong department got the paper so it wasn't found until April....I'm thinking, one the their employee's misplacing papers shouldn't be my financial burden for the next year!!!

 

[cbg]

Yes, it makes a very big difference. If your portion was taken out pre-tax, then they legally cannot make any changes except at certain, specificed times. What time that is will depend on your insurance contract year, but there is generally a one-month Open Enrollment just before the plan renews. When your premium is deducted pre-tax, that is the ONLY time changes can be made unless you have a life-status change as defined by Federal law. Your situation would NOT qualify as a life-status change under the law and your only recourse would be to wait until your Open Enrollment.

When your portion is taken out post tax, then it becomes not a legal issue but a contractual one. Most insurance contracts specify exactly when changes can be made. I can't say if all companies take this view, but the one I worked for took the position that a court order was binding on you, but not on them. A court order to you saying that you are not responsible for your child's health insurance is not the same thing as an order to them saying that they are required to remove the child from the policy. It's not that they won't remove her; it's that they won't remove her until the terms of their contract permit it. To the best of my knowledge, their position has been legally upheld. There's the potential for discrimination charges when they go against the contract; if they make an exception for you and remove your child outside the terms of the contract, but refuse to do so for someone else, there can be problems.

Your best bet at this point would be to prove to them that you did submit the request within the specified thirty days. Did you submit the request through your employer? Would they be able to back up your request? Talk to someone in your human resources department and see what suggestions they can offer - in my experience on both sides of that desk, the HR person who works directly with the insurance company often has internal contacts who can help.

 

[ShyCat]

If the mother is "covering" the child through Medicaid, won't the state expect to recover Medicaid payments from the father?

 

[vibbershniven]

Shycat...yes, all of my child support payments(over four hundred a month) go straight to Medicaid.

cbg...The insurance company admits that the request was sent on the 18th of March; however, they are saying that the wrong department had it and it wasn't given to the right dept. until April was here. They say that's my problem. My company fought with the ins. for about two weeks and then gave me the numbers and told me to deal with it. The insurance company knew about the request, because they are the ones that told me that (even though it was within the first 30 days) that they can't cancel a policy in the middle of the month. They changed the story three times! During the phone conversation it was even suggested quitting my job, then asking the employer to rehire me, becasue that would cancel all insurance policies. Then I would lose my three weeks vacation, seniority, and my personal insurance.

 

[cbg]

Frankly, I don't think much of your insurance company's ethics, but to be honest with you I can't think of a single way you can legally force them to remove your daughter from the plan outside of the contract provisions. Your ONLY hope is their admission that it was sent in March, and since they don't seem to have any plans to follow up on that, I can only suggest that you talk to a local attorney who is skilled in contract law.

 

[vibbershniven]

change of custody, qualifying event?

Question...isn't a qualifying event a change in custody? I got insurance to begin with because my wife and I are still married and I was entering a custody battle. When I filed for divorce I filed for my daughter, fully believing I would be awarded custody. Then a temp. order was issued on Feb. 11, giving my wife sole legal and physical custody(because she has other children and didn't want the kids separated.) It was that order that stated I needed to have insurance on my daughter. Then after a court hearing it was ordered that since my wife has full custody, that I shouldn't have to pay my daughter's insurance. Purely because my wife is on Medicaid with her 2 other children so no matter if I carried ins. on my daughter all child support would still go to the state. There was a change in custody!

The whole thing with the thirty days, has gotten me beyond frustrated. They admit to having the papers but won't honor the dates they were sent. Worse yet...I have a lawyer, the one who said the stipulation/order for her to be removed from my policy is all that I would need to get her off. Now he isn't even returning calls.

 

[cbg]

I did some research and yes, the change of custody would probably be considered a qualifying event. HOWEVER, even with a qualifying event, you still have the 30-day restriction. A change due to a qualifying event still has to be made within 30 days of the event itself.

I don't know what more to tell you, except possibly to try a different lawyer.

 

[vibbershniven]

I called the insurance company back this morning about the qualifying event. He said he would have to run it by his boss and he'd call me back. But see...they received the order on March 18th, that's 11 days after the actual event. They admit to getting the papers, so I'm hoping that there's a light at the end of the tunnel for me! Thank you so much for your help!!

 

[cbg]

I have one more possible idea for you but I need to talk to someone who's more expert than me in that area, so if the qualifying event doesn't take care of it, get back to me and I'll see what else I can come up with. I really hate it when companies try this kind of stunt - it makes all the rest of them look bad. The company I worked for would have taken responsibility for losing the form and it really bugs me that your company won't. Good luck and let me know what happens.

 

[vibbershniven]

Thank you so much, you've been more help than you know!! I did finally speak to my lawyer a minute ago...he said he would call the insurance company and fix it; however, in his language that means he'll sit on it for a few weeks while I pay for it. I'm hoping the calls that I put in will prove enough for them to step up the plate. If it isn't resolved, I'll be back here in a heart-beat!

Thank you again!

 

[vibbershniven]

CBG...are you still out there? The insurance company still says after everything I sent them they won't remove her from the policy! I even sent them their handbook with the words highlighted that proved I have the right to cancel her policy! I'm completely confused. My lawyer hasn't called yet(to the ins. company) and of course it would figure it's pay week, there goes another 65% of my income!

Did you find the possible idea?

 

[cbg]

I was waiting to hear if you had any success with the qualifying event. Answer me one question and regardless of what answer you give me, I'll check my final thought out with my expert.

Are they claiming that YOU sent the paperwork to the wrong place, or are they acknowledging that you sent it to the correct place and THEY mis-directed it?

For what I have in mind, it shouldn't matter either way, but just so I can give my expert all pertinent facts.

 

[vibbershniven]

I'm actually not sure of that one. My employer sent the information in. The insurance company said it was in payroll for awhile...but it was a policy change request form, it said right on it. So why it sat there for so long is beyond me. They didn't really lay blame anywhere.

Hope that helps. Thank you again!