Open Enrollment & Child Custody OrderIt’s that time of year again, and we don’t mean pumpkin spice, fall, or the holidays! It’s open enrollment season for health insurance right now, and if you have a child support order, there are a few things you should review before re-enrolling in your company’s benefit program this year.
Has either parent changed employers?
Obviously, a change in employment for either party could make a dramatic difference. Some companies offer plans with excellent coverage and low premiums, while other companies’ plans have strict restrictions on network providers or pass the full cost of the premium onto their employees.
Although the child support order usually dictates which parent has to provide health insurance for the children, the court can order either person to carry it if it makes financial sense and the coverage is similar or superior. For example, if the party paying support is self-employed, and the other party was working part-time and had no access to benefits through their employer at the time the order was finalized, it might have made sense to order the self-employed party to provide the coverage. But if the other parent has changed their status from part-time to full-time and now has access to superior insurance benefits, it may be better for that parent to provide the insurance.
At the end of the day, health insurance for the children is a component of child support, so the cost has already been considered by the court when they calculated the support order. And as long as the insurance costs less than 5% of the parent’s gross income, it will be considered reasonable. However, if the child was previously being covered by Medicare/Medicaid and private insurance is now available through a parent’s employer, the court may force the issue. If private insurance is available, the state should no longer have to provide that coverage.
Splitting uncovered medical expenses
Anyone with children knows that even with insurance, there will always be medical bills. Check the new plan to see if copays are increasing in 2022. If they are, how will that impact your obligations regarding the cost of uncovered medical bills? And if the current plan is increasing their copays for the types of services your children need, is it still the best plan for your family? Even though out-of-pocket medical expenses for the children are usually split between the parents based upon their percentage of income, a substantial change to coverage may be reason to re-examine who is carrying the insurance and how large those medical bills might become.
Secondary insurance coverage
If both parties have access to insurance, both parties could be ordered to provide it. In these situations, the medical provider will submit any charges to the primary insurance carrier first, and then submit any remaining charge to the secondary carrier. While this may cut down on the parents’ out-of-pocket expenses, it doesn’t always offset the cost of the secondary insurance. However, it may be worth it if there is an ongoing medical condition with your child(ren) or very high medical expenses.
Who has the best insurance?
Some employers now offer a dizzying array of choices; multiple carriers and multiple levels of plans from which to choose. It can take a spreadsheet and a mathematician to figure out the best deal, but take the time to really figure out your expenses under each plan. And once you know what your best option is, compare that to the best plan the children’s other parent can get. Don’t just assume that the selections you made last year are still the best. Premiums and deductibles both seem to increase every year. If the party providing insurance experiences a drastic increase in costs, a review of the support order may be necessary to ensure that it is still financially fair based on the income differential.
Check your network!
If it’s important to you that your children have continuity of care and are able to continue to see the same primary caregivers, double check that those providers will be considered in-network next year. And if the other parent is the one providing the insurance, insist that they verify in-network coverage for the children’s doctors as well. Especially for children with chronic or serious illnesses, it could be devastating for them to lose their favorite doctor. Likewise, it could be financially devastating for you if you suddenly have to start paying out-of-network co-pays and a higher deductible.
Know your deadline
Every company allows a different amount of time for open enrollment, and they each have their own deadline for enrollment. Make sure you know when yours is, and make sure the other parent knows when theirs is. While some companies might roll over your selections from year to year if no action is taken, others require you to actively make selections or you will not have coverage. If the other party is responsible for providing the insurance, you will want to make sure they know their deadline for enrollment and that they don’t miss it.
Free legal consultation
If changes to your medical insurance plan leave you with questions about your child support order, call an experienced custody lawyer at Kirkland & Sommers. We can review the types of changes that concern you and help you decide how to approach it. Most of the time these issues can be resolved with an agreement between the parties, and it’s not necessary to go through the courts. For these and any other divorce-related questions, schedule your free consultation with an experienced family lawyer at Kirkland & Sommers today.