Question
What is the name of your state? West Virginia
Hi, I'm trying to find out if my ex-husbands medical insurance would still cover me after we divorced. It is Blue Cross and Blue Shield Insurance, he is on the family plan, has not taken my name off it even though we have been divorced for a year and a half, he pays 20% of the premium himself, emplorer pays the rest. It won't save him any money to have my name taken off as he has to carry it on our daughter, so he hasn't bothered to do so. Some people have told me since he pays for part of the premium, I am still covered, he thinks so too and tells me to use it if I need it. We had a civil divorce, but I am afraid they are wrong and if I used it, there would be problems that would arise. Can anyone advise me? Thanks!
Answer
This is less a legal question and more a contractual question. It depends upon whether or not you are considered an eligible dependent under the insurance policy.
If a divorced spouse is considered an eligible dependent, you've got no problem. I have to tell you that while this is possible (no law prohibits it) it is extremely unlikely.
If a divorced spouse is not considered an eligible dependent, you could be facing a host of problems. Keeping an otherwise ineligible dependent on the plan is fraud, for which the insurance carrier can cancel the coverage and for which your ex-husband can be fired.
What should have happened is that at the time of the divorce, the change in status should have been reported to HR. At that time, you would have had the option of picking up the coverage at your own expense for up to 3 years if you were no longer eligible under the employer's plan.
Just because he pays part of the premium doesn't mean he gets to decide to cover someone who is not eligible.
Answer
Thanks so much for your quick response. That is exactly what I was afraid of, I was pretty well sure if I used it, it would be Insurance Fraud. I just got the policy out and read everything I could find on eligible dependants, and couldn't find anything other than spouse, kids, dependants. Nothing states anything about a divorced person, separated or of such a nature. I did not know though, or have any idea he could be fired from his job for not informing them. Once again I thank you for your quick response.
Answer
If you have not used the insurance then I doubt that they would fire him. I'm not saying they won't slap him on the wrist, figuratively, but since he'd have to keep the family coverage for your daughter fraud would not have occurred in that regard. It would only be fraud, or at least it would only be the type of fraud anyone would care about, if you had had claims paid when you were not eligible for coverage.
However, you should take care of this situation immediately. The longer you wait the harder it will be, and the more likely that something will come up for which you would need medical coverage.
Under the law, they are required to allow you to stay on the insurance at your own expense for up to three years. After that you are on your own as far as his insurance is concerned. If there is a court order in place that he provide you with coverage, he will have to find you an individual policy at that time. If no such order exists, you will have to find your own insurance then.