Health Insurance Question

[dorothymantooth]

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

My DH, DS and DSS (who all live with my husband and me) are all covered by my health insurance through my employer. My husband also has a daughter who lives with her mother who has no health insurance. My husband just started a new job and recently received notification that he must have his daughter enrolled in the health insurance he can get through his new job. He had planned on opting out since he's covered through me. Now he must pay for family health insurance for his daughter only.

Is it possible for her to be covered under my plan instead so we wouldn't have to pay for two plans? Is that something a judge could/would order? Is it legal?

Thank you.

 

[cbg]

Who notified him that he was required to cover his daughter?

It is entirely up to your employer's policy whether or not she qualifies as an eligible dependent. If she does, then at the next open enrollment or when she experiences a qualifying event as defined by the IRS, you can add her to your policy. If she does not qualify as an eligible dependent, then you cannot.

A judge can order that your policy cover her if and only if she qualifies as an eligible dependent. A judge cannot order your policy to cover her if she does not. A judge cannot require your policy to violate their own plan.

 

[ecmst12]

Wouldn't he WANT to cover her, so she wouldn't have to be uninsured anymore? After all, if she were to incur catastrophic medical bills, he would be equally liable for them with mom.

 

[dorothymantooth]

He received a Medical Support Execution for Support Enforcement notice from the County Support Collection Unit. He also received notice from his employer that they have to enroll her by law.



"Wouldn't he WANT to cover her, so she wouldn't have to be uninsured anymore?"

Of course he wants her to be insured, it is the cost we are hoping to keep to a minimum. If she can be on my health insurance, it would cost us nothing more; if she has to be enrolled on his he will have to pay family rates, which are $200+ monthly. My coverage is also better than his.

 

[cbg]

The first question you have to answer is whether or not she is an eligible dependent under the terms of your policy. Your HR office or Benefits office will be able to answer that question. If she is not, then that's it, case closed.

If she is eligible, then step two is to see whether the medical support order is specific to his plan. If it is, then she goes on his plan, case closed. If it's not, then you call the agency that executed the order and request that it be re-issued to your employer.

Step three is to determine if your plan recognizes such orders as qualifying event. They probably do, but if they do not then that's that, case closed - at least until your next open enrollment period, at which time you should be able to add her regardless. (Her obtaining new coverage with your employer will, at that time, be a qualifying event to drop the coverage with your husband's employer.)

So, if she is an eligible dependent under the plan AND the medical support order is not specific to your husband's plan AND the issuance of such an order is a valid qualifying event to add her mid-year, then you can. If any of those qualifiers is not the case, then you can't.

It really is that simple.