Health Insurance Company balked when they saw how many people in my family.

[Amy70]

What is the name of your state? Rhode Island

My husband just started a new job which offers 'decent' health benifits. We filled out the paper work and he turned it in. The Human Resources Dept. first reacted poorly to the fact that he listed 7 dependents. (me and our 6 children). When they noticed that 3 have different last names than my husband they said they are not responsible to cover my three children from a previous marriage. We have never had this problem before with insurance companies. My x-husband and I made a court agreement that had him paying for health insurance however, the judge stressed upon us that if we decided to change this in the future it only means that my x-husband pays more support in lieu of providing medical coverage. The judge stressed that he doesn't like to see people coming back to court for such matters so to please try to rearrange things without the courts intervention. So we did. Knowing that the law states that step children are eligible for coverage through the step parent, my x and I agreed to the higher child support instead of medical because there is no need to have him pay for a family plan if my huband can provide insurance since he already has to have a family plan for his own children. Now the insurance co. told my husband they won't cover my children/his step-children. Can they do this?

It isn't an HMO. It is one of those insurances where you pay a family deductible and then the insurance pays 80% thereafter. Do they have a loophole that gets them out of covering my kids? Further they told my husband that the only way they would even consider it is if I proved that the court waived my x-husbands obligation to pay for medical benifits. Obviously since we didn't go back to court to change this, I don't have proof that he doesn't have to pay. It would take months to get back into court to have the paper work changed. It is a hassle to go back for just this reason, considering that my children are my husbands step children and are entitled to insurance benifits through my husbands employer just as his own natural children are.

Any input would be greatly appreciated.

 

[djohnson]

I'm not an attorney but I have never heard of a law saying they had to make insurance available to step children. To my knowledge it is up to the company to set the policy they want, especially if they are paying for some or all of it. I know of places where it is not a problem to claim a step child and others that require proof that you claim them on your income tax, and others that want a copy of the court order. I don't think its any thing unusual about the situation. Those are questions that should be asked before accepting a different job. Benefits can add up to alot.

 

[cbg]

With the exception of the state of Hawaii, an employer is not required to offer health insurance at all; I don't believe that even in Hawaii they're obligated to offer it to any dependants.

It is up to the company and the insurance carrier to determine between them who is an eligible dependent. While a great many companies do cover stepchildren, I'm not aware of any law making it mandatory.

In addition, a court decree is binding on the parties involved, NOT on the insurance carrier. So even if you had a court decree requiring that you and your husband provide coverage on all of the children, if some or all of the children did not qualify under the plan, the law would not require the plan to make an exception. It would require you to find a separate policy to cover the children.

While it may or may not be fair, I see nothing in what has happened that is illegal.