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Parenting Issues This forum is for discussing any of the parenting issues involved in your divorce, including parenting of step-children.

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  #11  
Old 01-27-2021, 05:30 PM
Lolita123 Lolita123 is offline
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Quote:
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
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  #12  
Old 01-29-2021, 09:36 PM
enchantedowl enchantedowl is offline
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Are the step-parent's plan premiums for the children's coverage considered a section 7 expense then?
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  #13  
Old 01-30-2021, 11:16 AM
rockscan rockscan is offline
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Quote:
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 dont charge for kids but if the step parent has to pay for benefits then it isnt 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.


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  #14  
Old 02-01-2021, 02:57 PM
Ange71727 Ange71727 is offline
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Quote:
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 spouses 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 doesnt 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.


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  #15  
Old 02-01-2021, 03:36 PM
Alpinist Alpinist is offline
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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.
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  #16  
Old 02-01-2021, 03:50 PM
rockscan rockscan is offline
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Quote:
Originally Posted by Ange71727 View Post
Beware of this scenario:

Parent 1 is primary insurance
Parent 2 is covered under spouses 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 doesnt 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.


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Then he committed insurance fraud and you need to reach out to his spouses insurance company and report it. He should also be paying his share of the expense over and above what was covered by his wifes plan.

But then again, your ex is a super ass who pulls these stunts. Add it to your list of abuses for the next time he cries foul.


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  #17  
Old 02-01-2021, 04:05 PM
Alpinist Alpinist is offline
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Rockscan is right. If you have paid for an expense and their insurance plans paid anything toward it they need to reimburse you right away.
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  #18  
Old 02-01-2021, 05:20 PM
Ange71727 Ange71727 is offline
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Sorry its not super clear now that I read it.

Child gets some medical services.
Both parents pay towards this service.
We both have insurance coverage for the child - my ex through his own plan, and through my spouses plan (stepdad) on my end.
Receipts issued even state explicitly who paid what. We each submit through our plans.
Insurance company will only issue the reimbursement through the Primary parents plan (my ex).
This means he receives back his reimbursement, for funds paid out of his pocket AND my reimbursement for funds paid out of my pocket.
Insurance company considers it a done deal at this point because theyve paid out what theyre reimbursing and dont care to who.
At this point, a reasonable human would return the money to the party who actually paid it out.
My ex is not a reasonable human. He actually has accused ME of insurance fraud, saying I had no business using his benefits to cover our child. He clearly does not understand how it works.
Therefore I am currently out $1000 for two separate claims.
At one point he said he would just mail the money back to the insurance provider, but that hasnt happened. The insurance company also told me that unless he mails it back with specific instructions to reimburse it to my husbands policy number, that theyd not be sending me any money as its considered his right now.
This is going to just keep occurring as well.
Its on the list of items we are hoping to address at the upcoming trial.
I am surprised I dont hear others talking about this matter - it must occur to other people in similar situations to me.
And yes Rockscan, I know you know this would be typical of him.
As infuriating as it is though, my husband seems to think its going to hurt him in front of a judge to have been so uncooperative.


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  #19  
Old 02-01-2021, 05:30 PM
rockscan rockscan is offline
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It has been discussed in other threads.

In your case what should have happened is this:

You pay the money up front and submit to your benefits company. You send him the receipt and he submits to his company. You can also submit to the new spouses companies on both sides. Insurance reimbursements go back to you IN FULL and any remaining amounts are split according to section 7.

Namely, expense is $1000. Your company pays $300, his company pays $300, other companies dont exist. You pay out the $1000 up front, he pays you the $300 and then you split the remaining $400 proportionate to income (say its 50/50 so he pays you $200).

I wonder if you can just get the insurance info and have the medical provider bill direct?


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  #20  
Old 02-02-2021, 09:54 AM
Ange71727 Ange71727 is offline
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So what happened is we both agreed to pay our share and each submit through our own insurance. He didnt want to have to deal with me, and frankly I didnt want to deal with him either. We divided up the cost proportionately and knew the full amount was going to be covered. It seemed like a win-win....
Except that when I submitted my portion through my husbands account, I was forced to indicate there was an additional policy covering the child (ex and current husband are both with the same company). Thats fine, because its insurance fraud to not indicate that, but it meant that the reimbursement went through the one plan only - the primary insurance ie. ex husbands.
He should have simply just e-transferred the amount over to me. But he chose to power trip and keep my money.
The dentist is never a problem because they direct bill and we dont pay out first.
Any time an agency expects payment first (which is the case for many places), I am going to run into this problem.


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