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  • Children covered under multiple employer benefits

    Does anyone have something like this going on? If both parents and both step parents each have separate benefits covered by their employers, can a child be covered by all four plans?


    For example my child may need braces. My benefits don't cover them, assume child's mother's benefits don't either. But child's step mother's benefits would cover them at least partially if the child was added to her plan. Is that at all possible?

  • #2
    That would seem to be up to the step parents insueance providers, however it is highly unlikely.

    Comment


    • #3
      Yes you can, it can be a pain in the backside. All by date of birth.

      DaD in march, insurance first, Mom in June next insurance, Step-dad september his next and step mom december this one last.

      Good luck.

      Comment


      • #4
        It’s possible if the steps married or common law and have family plans.


        Sent from my iPhone using Tapatalk

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        • #5
          Having the kids on a step parents plan benefits everyone as the costs are reduced. In your case, if you both dont have benefits you would be splitting $4000 in expenses. If the step parents have benefits that cover $2000, you would then split the remaining net cost.

          Almost all benefit companies now cover step children as they consider your spouse your “dependent” therefore the children are too. I was able to put my partners kids on my benefits even though we arent married.

          You should check with your benefits provider on how they apply them though. Depending on custody situation (and its written clearly in my partners benefits book, dont correct me) if goes custodial parent first, access parent, custodial spouse, access parent spouse.

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          • #6
            I have had this in place for a while, my kids were covered through both their father and stepfather but it did take quite a while for them to figure out the order of benefits for COB due to shared custody situation... Now that DD is 21 (graduated & overage) for one plan, trying to update info for the plan that goes to 22 is proving to be a challenge.

            Comment


            • #7
              My kid is also covered under 3 insurance plans. Mine, my ex's and my wife's. It hits my ex's first, then what isn't covered goes to mine, then my wife's.


              My wife had family benefits for years as my work insurance was expensive, so she was the only one with coverage for a while. Then my work covered 100% family insurance, and my ex got a new position with better benefits. It works out best for the kid and helps my pocket book at the end of the day.

              Comment


              • #8
                The way insurance pays when there are multiple insurance involved is the same for all insurance across Canada. This is dictated by the Canadian Life and Health Insurance Association’s (CLHIA)
                1- SHARE CUSTODY When both parents have plans and their children are covered under both asdependents, the plan of the parent with the earlier birth date in the calendaryear pays first.
                Example 1:• Father’s birthday – October 11• Mother’s birthday – September 21Therefore - Mother’s plan pays first - Mother’s birthdate comes before Father’s inthe calendar year.


                If both parents have the same birth date, the plan paying first is based on theparent’s given name that occurs first in the alphabet.


                Example 2:• Mom’s given name is Jane• Dad’s given name is StephenTherefore - Jane’s plan pays first - the name Jane comes first alphabetically.


                In cases of Single Custody i.e., when one parent has custody of the child(ren),
                The plan of the parent with whom the child resides, i.e., the plan of the parent withcustody, pays first.
                The plan of the spouse of the parent with custody pays second.
                The plan of the parent not having custody pays third.


                Example 3:A child lives with mother and her new spouse.Therefore - Mother’s plan pays first.
                Mother’s spouse’s plan pays second.
                Father’s plan pays third.


                In a case of sole custody, it's not the DOB that are important, it's mom then partner (if applicable) then dad, then partner (if applicable)


                See this link for complete document:
                Brochure_Guide_To_CoOrdinationBenefits_ENG.pdf (clhia.ca)

                Comment


                • #9
                  If there is shared custody, and both parents have repartnered, what is the order then?

                  Comment


                  • #10
                    Parents with joint custody :

                    1. Plan of the parent with joint custody with the earlier birth date
                    2. Plan of the parent with joint custody with the later birth date.
                    3. The plan of the spouse of the parent in #1
                    4. The plan of the spouse of the parent in #2

                    Comment


                    • #11
                      Originally posted by Alpinist View Post
                      Parents with joint custody :

                      1. Plan of the parent with joint custody with the earlier birth date
                      2. Plan of the parent with joint custody with the later birth date.
                      3. The plan of the spouse of the parent in #1
                      4. The plan of the spouse of the parent in #2


                      yeap exactly.. goes back and forth

                      Comment


                      • #12
                        Are the step-parent's plan premiums for the children's coverage considered a section 7 expense then?

                        Comment


                        • #13
                          Originally posted by enchantedowl View Post
                          Are the step-parent's plan premiums for the children's coverage considered a section 7 expense then?

                          Most plans don’t charge for kids but if the step parent has to pay for benefits then it isn’t required to have them. However, if it works out to say less than $10 a month and their spouse will have to pay $500 a year for things like braces out of pocket, that $120 is a good investment.


                          Sent from my iPhone using Tapatalk

                          Comment


                          • #14
                            Originally posted by Alpinist View Post
                            Parents with joint custody :

                            1. Plan of the parent with joint custody with the earlier birth date
                            2. Plan of the parent with joint custody with the later birth date.
                            3. The plan of the spouse of the parent in #1
                            4. The plan of the spouse of the parent in #2

                            Beware of this scenario:

                            Parent 1 is primary insurance
                            Parent 2 is covered under spouse’s plan (step-parent) and does not have their own plan
                            Children are covered under Parent 1 and step-parent (4 on this list).


                            Coverage of the child must proceed through the “coordination of benefits” between any plans. At the time of making a claim, most plans ask the question “are there any other plans covering this child?” and prompt you to indicate additional policies. If Parent 2 & step parent pays for anything out of their own pocket, all reimbursements will still go to Parent 1 because that is the primary plan (in my experience). Parent 2 or their spouse could have an earlier birthdate than Parent 1 even, but it doesn’t matter. Parent 1 is primary and gets the reimbursements.

                            I am out $1000 currently because of this rule. Ex just pocketed my money even though I paid for the services (for our child) I made the claim for.


                            Sent from my iPhone using Tapatalk

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                            • #15
                              Not sure if I am understanding correctly what is going in in your scenario.

                              If you have paid for the total claim expense upfront (prior to any insurance payments) they should reimburse you for any amounts their insurance contributed toward that claim.

                              Comment

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