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Financial Issues This forum is for discussing any of the financial issues involved in your divorce.

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Old 09-08-2016, 12:35 PM
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Default Benefits Deductible

I haven't heard anyone discuss this before so I will ask.

How does the benefit deductible get calculated for those with benefit coverage?

Example: medical expense of $500 is submitted. Deductible is $120. Coverage is then $380. Is the $120 then split according to proportionate share?

My partners kid needs dental surgery and mom isn't sure it will be covered (or shes reached her max). My partners benefits have a $120 annual deductible on all dental expenses. So if the cost is $500 and she has the doc submit to his benefits, would they then split the deductible by s7 split?

(Its not enough for the tax receipt so that won't come off.)
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Old 09-08-2016, 12:40 PM
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IMO, the deductible should be considered a shared expense.
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Old 09-08-2016, 01:04 PM
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Thats what I thought. Just wanted to make sure.
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Old 09-08-2016, 01:25 PM
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At my work I pay a portion of my my salary for my benefits, it was agreed that I would not seek renumeration for this from the ex. She doesn't pay these but has to pay deductibles and it was agreed that she should pay these herself.

Not sure that a deductible is considered S7 expense as it is in replacement of benefits fees that would be paid normally. What would stop one party from just being under insured with a crappy plan and just relying on the other party to pay their part of all the deductibles?
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Old 09-08-2016, 02:00 PM
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Her plan is actually really good. Mine is as well. He works for a private sector company with low tier benefit coverage. He gets most covered but there is still a deductible. The problem is I could see her demanding he pay the full deductible since its "his problem". This knowledge will help when he responds (he had to ask if the dental surgery is covered) with "you have my benefits info, please have the clinicians file with company automatically."
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Old 09-08-2016, 02:10 PM
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My plan offers different tiers, some of the lower ones require more deductible but less cost up front. I am pretty sure this is always an option but I could be wrong. IMO deductibles should not be considered S7 expense, I don't think they meet the legal requirement of special or extraordinary.

If we were talking about costs not covered by the insurance it would be a different story.

Last edited by calicodacat; 09-08-2016 at 02:12 PM. Reason: Adding
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Old 09-08-2016, 03:00 PM
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Well his portion will be about $50 so hes not going to be an ass about it. I just wondered if it was a case of he has to pay the full amount because its his plan. There will also be a deductible for eye care too but she also submits expenses for cleaners and cases etc which the eye doctor charges for.
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Old 09-08-2016, 04:20 PM
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The FCSG says that S7 expenses include "your child’s health-care needs that exceed $100 per year if the cost is not covered by insurance (for example, orthodontics, counselling, medication or eye care)". (from Step 7: Determine if there are special or extraordinary expenses - The Federal Child Support Guidelines: Step-by-Step)

So yes, the $120 deductible would be shared proportionate to income.
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Old 09-14-2016, 09:57 AM
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Agreed. Definitely a medical fee expense that should be shared.
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Old 09-14-2016, 10:58 AM
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Would that then include premiums for insurance?
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