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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 02-28-2016, 06:06 PM
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Default Medical Benefits through employer

I haven't been on the forum in ages...lots of issues resolved, some still ongoing.

One thing that has come up is the health benefit coverage my stbx has through his employer. Our separation agreement (as of September) states "Stbx shall maintain the children and (me) on his medical benefits plan for so long as it is available to him for their benefit."
He's now claimed it has been cancelled (as of Dec 31 - with no notice) because he has not lived with me for over 1 year. Well - I expected him to drop me as soon as he moved in with a recent girlfriend. Divorce is not final but that's just a matter of time. And wanted to make sure I was covered so I have my own private health coverage.
But my interpretation of this clause was that unless the employer removes coverage then he is to continue the current plan (or if he changes jobs etc) If it's "available" then it continues. So now the kids have no coverage. They both live with me.
Youngest is 14 so this is only needed until he enters university and can be covered under a student plan. Eldest starts university in September.

What can/should I do about this?
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Old 02-28-2016, 07:10 PM
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He should still be able to put the kids on his plan. Because he lives with his gf only she can be his "spouse" but kids dont matter. My partner has me on his benefits and his kids as well.
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Old 02-28-2016, 07:35 PM
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Since you're only separated and the order state he must keep you on his plan, he must follow the rules. Once the divorce is officially pronounce, you are on your own. The children will remain on his medical and dental plans until they reach the age of 18 or are no longer at post-education and no longer considered children of marriage.
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Old 02-28-2016, 07:52 PM
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I have asked him to provide documentation from his employer and/or insurance provider confirming cancellation and indicating reason why the policy has been cancelled. I assume if he lost his job that would be reason - but he hasn't. And I doubt the insurance provider just called him out of the blue and cancelled the kids coverage. His answer so far is "it's not available so I'm not responsible". I've never heard of an employment benefits plan just suddenly ending. This is a large employer so not a small company.

rockscan - how long would you need to be living together to be considered "spouse" by the insurance company? My own private coverage wouldn't cover my bf if we moved in together until we were living at the same address for at least 12 months. Until then, we would still be considered "individuals" rather than "spouse" and the cost would be two policies.
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Old 02-28-2016, 08:26 PM
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Once I moved in I was able to put him on my benefits. We had been living together for over a year when his benefits started so we were well within the timelines.

Do you know the benefits company? You might be able to call and ask some general questions?
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Old 02-28-2016, 08:38 PM
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Yes I know the company. I'm planning on calling them this week but they may not be able to provide answers so just getting an idea what others have experienced.
I'm not concerned about my own benefits. I had purchased my own plan late in the fall as I thought (just based on his history) he would drop me without notice and before the order stated he was allowed. I had quickly looked through the provider website before the agreement was signed and I thought it said until "proof of divorce" so I thought he would be required to keep me on until it's all final.
I'm surprised at him dropping the kids though. And I wonder if he really has - he may just not want to send my receipt into his provider and leave me with the bill. Either way - just need to know what's going on so I can plan moving forward.
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Old 02-28-2016, 08:42 PM
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Hes still responsible for a portion of the expense even if he doesnt have them covered and if he makes more than you he pays more so hes pretty stupid to play this game.
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Old 02-28-2016, 08:52 PM
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You're assuming he reimburses me for these expenses... That's the game.

We're going to court on another item that absolutely needs to be resolved (he's more than 4 months over a court ordered deadline) and the medical expenses are going to be much higher (two dentist visits, 4 therapy sessions) between now and then. I take the kids to all their appointments so I'm the one that ends up paying and then chasing for his share...

I guess I'll call the provider and see if they can tell me what the policy is regarding separation etc. Meanwhile he has some time - and notice from me - to get himself organized and hopefully do the right thing and either put the kids back on the plan and/or pay his share of these expenses (which is quite high).
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Old 02-28-2016, 10:38 PM
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Even if he puts the kids back in now these expenses won't be covered as they occurred before coverage. I work for a large corporation and in 2014 they redid their whole benefit coverage. We lost some big ticket items such as orthodontics. It was a cost savings measures. While we are still covered for drugs and other items our maximum amounts were lowered as well. I doubt a company cancelled all benefits but it could happen. Doesn't hurt to phone and find out

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Old 02-29-2016, 01:14 PM
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ok a quick phone call answered the easiest questions. Separated spouses remain on benefits until divorce is final. New spouses cannot be added until they are living in same residence for 12 months. Children remain on plan until they are no longer dependents (including through post-secondary) regardless of which home they are living in.

He's done this against the court order.

So what do I do? I am going to court on another issue and can include this item - but other than making him looking like a lousy person in front of the court what can anyone possibly do about it?
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