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Are we being fair???

Posted by JensNatPat (My Page) on
Tue, Jun 21, 11 at 22:27

Is someone so crazy that you can't think they could possibly be that crazy so it makes you think you are the crazy one???

BM is supposed to cover health ins. Court ordered.

DH took it over when she quit her job. She started working full time a year later and we never asked her to take the health ins. back because why change it if no need to. DH then lost his job a month ago. He asked her to take health ins. back and she said ok no problem.

We find out yesterday (a month later) she never signed her up. She said she was unable to add her to her "free" state healthcare (whatever that means, she works full time). DH told her to get health insurance through her job and she said no b/c she'd have to pay for it. Imagine that. So I put her on my insurance. (She has possible Lyme and is going to the dr. tomorrow).

We sent an email to BM as we've had problems in the past with getting her to help pay for out of pocket.

We asked her to pay out of pocket expenses and nothing else. The kid is relatively healthy so she needs about $75 worth of copays a year for well checks/dentist. Add in another $200 or so for shots or cavities or whatnot. (I'm not counting all the frivolous co-pays she creates for taking her to appointments for imaginary ailments)

We pay $550 year to cover her. So BM is making out in our proposal.

She said since SD lives with her most days she doesn't feel she should have to pay 100% of copays because she takes on the brunt of the financial burden of raising her. Um duh does DH not pay CS??? So she wants us to pay 1/2 of all copays as well.

So she thinks DH should cover cost of coverage AND pay 1/2 on top of that.

Please tell me I'm not crazy.


Follow-Up Postings:

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RE: Are we being fair???

What's the court order say about the extras over the actual providing the insurance? Was it assigned 50/50 or she/he? Actually I think you are providing a fair proposal with the insurance provided by you and the expectation that she cover the extras. On the other hand, could depend on what unforeseen incidents can actually (and do) happen to even healthy children.

Is there a deductible that she would have to cover under her part as 'extras'? For example, depending on what plan I would choose from my employer I could have no deductibles and only co-pays or I could have $500 deductible per member and 10 to 20% of the bills. Even if I were to choose the no deductible and co-pays, an in hospital co-pay would be $275, and ER visit $200 (kids do have accidents, get hurt, and occassionaly even get serious illnesses). With my insurance I can not change plans nor add people except for one set month a year, with the exception of a marriage, new baby, adopted child, court ordered guardianship blah blah.

No clue what she's talking about with her state's 'free' insurance. In my state she would likely be refering to Kid Care which our last governor smashed in covering kids up with zero to x amount in premiums (based on income and family size). And if it is something along the lines of that she is talking about, her income can't be all that much to get it totally free, some of that again, would depend on family size.

To be fair, without knowing what she is actually refering to, I will say just because she works fulltime might not necessarily mean she could afford her workplace's plans or perhaps the bottom line one without much coverage and all kinds of loop hole clauses. Obviously, she did before but I have no clue as to if she can now or if the insurance carrier she has now is similar to the previous one she had.

But again, to your original question. I don't think it's unfair to think if you provide the insurance she come to an agreement of what part/s she would pay of the noncovered parts. If the court order puts insurance on her, she's kinda nuts to fight over now just paying a bit of extras...she could be paying the premiums and the extras.


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RE: Are we being fair???

Well... Lol that's how it is in my order. It's just recently changed but what it is was for 6 yrs prior was
non custodial pay 20% of net income in support
Non custodial carry health insurance (dental ins is not required)
Custodial and Non custodial split 50/50 out of pocket expenses for in net work care. Any out of net work is paid by the party that incurs the charges. (whoever takes her to dr out of network)

Now the order is (my request) I cover health care. Dad reimburses 1/2 of monthly premium through medical support order with child support.
20% of net income
Both parties pay 50/50 of out of pocket expenses for medical in net work.

I know that is not what you wanted to hear but it's not uncommon. It's standard here. I asked to provide health care because I had a better policy than he was providing and he was ordere to reimburse 1/2. Otherwise, he would carry the insurance and reimburse 1/2 expenses and pay 20%. And according to the judge when he complained that 20% took away from his 'new'family, what he pays doesn't even begin to cover it which in my opinion, is true.

They also said that our Dd is not very sick and didn't need much coverage. That is true but it has not always been the case. Some years she is seen once for a well check up and another year, she had strep throat 8 times. They were going to have to take her adnoids out and she never got it again.... That was a busy year. Another year she had really bad allergies but now she is regulated on over the counter medications so we don't need to go to the allergist unless it gets bad. So far nothing this year but last year, she was seen several times until they figured out what would work.. so I never 'know' what year she will be sick but it's a relief to finally have secure coverage.


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RE: Are we being fair???-- something else

I wanted to add... You pay $550 a year in premiums.. That is about what my ex was paying also. But my deductible was $1500. So I had to pay out of pocket to $1500 before insurance stepped in and paid 80%.

My insurance is $314 a month. It's a lot but it's so much easier for it to come out of my pay before I see my check than to have to come up with an unexpected $325 when Dd needs to see her allergist once a year and then in a couple months another $400 for this or that until I hit $1500.
I'm covered as a benefit by my employer, no out of pocket premiums. So our deductibles are combined. My Dh is notorious for being sick... So we reach it pretty quick and then we don't have any extreme out of pocket expenses. Dd was on prescription meds and his ins did not cover, so that was $100 a month, now it's $15 ... (she's not on it anymore but when she was, it was NICE to not pay full price).


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RE: Are we being fair???

Just curious? Is that $550 a year in premiums to cover JUST THE CHILD? Does it include dental/vision?

My DH pays over $700 a month for the family plan. We also have a $1000 deductible per person/$2000 per family plus we still have $30 office visit co-pays & pay 20% of all other services. An ER visit co-pay is $180 plus 20% of all services... my last ER visit cost $500 for a lab test & exam.

Even though DH and I pay EVERYTHING... DH pays the insurance AND I've paid 100% of all SD's medical/dental expenses.. even though BM is ordered to pay 50%. He's taken her to court twice for refusing to pay & they've done nothing to her except give DH a "judgment" which he can't collect because she won't work & won't have a bank account because DCSS levied the last bank account she had... she successfully got the money put back into her bank too.

I don't think you're crazy but I do think you're lucky she is willing to pay anything considering the "mothers" in my situation (BM & DIL) don't feel any obligation to contribute financially to their children whatsoever.


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RE: Are we being fair???

The out of pocket difference between covering just myself and adding her is $550 per year.

DH also agreed to pay 1/2 of all emergency (hospital) visits and 1/2 of anything over $500. Our deductible is $750 per year, but....it only applies to cat scans/x-rays/MRI's. Everything else is covered. This is for Dental/Vision/Health which BM asked for.

Our opinion is if she covered health ins. we'd only be paying 1/2 of out of pocket (and that's only b/c we want to do the right thing) even though there's no court order saying he has to. So by only asking her to pay 1/2 of copays we think she's actually making out better. The other option is for her to cover the cost of healthcare and pay 1/2 of out of pocket.

In NJ if you have a "family status change" you can add someone to your ins. out of the open enrollment dates. Her daughter lost her ins. and that would qualify for a family staus change.

There is nothing in their order that covers out of pocket expenses.


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RE: Are we being fair???

Then it does sound as if DH is offering a fair deal. Be very clear in his written proposal to her so she would understand that the 'half of anything over $500' would mean exactly what he think it means. Don't leave the wording up for room of interpretation or misunderstanding.

Both parents should count themselves lucky you yourself have decent insurance and can add SD to it. Being it is you providing it, I don't think it leaves BM much room to be unreasonable on the conditions.

Hope all goes well for SD today


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RE: Are we being fair???

I think you are reasonable and fair in asking her to contribute, but I also hear her point that if a kid lives with her she already holds majority of a burden (even if dad pays CS it cannot be compared to actually raising a child). My ex also liked to say "well I am paying CS". It took him years to realize what it means living with the child full time versus paying CS.

I would consult with attorney what is fair in your circumstances.

Status change is having a new born or similar things, I am not sure what you described qualifies for status change. Maybe in your state. When SD's BM dropped her off her policy with no reason and without saying anything, SO could not get her on his because open enrollment was over, he had to wait for a new cycle. When DD graduated college and I had to drop her off my health policy, i called and they told me to wait until open enrollment period so i can drop her, until then i could not.


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RE: Are we being fair???

In my state, when our last governor rammed through the kid/family HC plans, there is a requirement about length of time. The fear was people already on decent plans would dump their current plan and apply for the state kid program. So if I remember correctly without going to look it up, there is a waiting period. There must be no coverage for x amount of time to qualify. Perhaps this BM ran into something like this when she thought she could just automatically get SD enrolled only to find out no?

Wow, PO1. They made SO leave her on until open enrollment? Here through my insurance they would have booted her off at right about midnight of the day of graduation. I did get a letter when my oldest son was about to 'lose' his coverage due to age but that if he were to be a fulltime student I had to send in proof and coverage would continue.


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RE: Are we being fair???

no, justmetoo, that was my DD that had to be left on my policy and it was only like a month before open enrollment kicked in, she graduated from college in July and open enrollment started in September. BTW i was never asked to show any proof of her being enrolled in college(which if asked I had a proof of course). i wonder how many people keep their kids on their policies when they don't qualify anymore.

What happened with SD is that mom took her off health policy (even though they previously agreed that she keeps her in) and didn't tell anyone, she had no premiums and no deductibles and 5 bucks co-pay, and mom is wealthy do she just did it to be nasty, no other reason. She does things like that to SDs all the time.


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RE: Are we being fair???

Po1...I totally agree that paying CS cannot compare when living with a child full time....IF....you are actually taking care of the child. She has free child care with her Mom who lives with them and she buys the kid food. That's about it. We buy all her clothes and shoes and pay for the extracirricular activites. Ocassionally we will also buy her toilitries that she asks for to have at her Mom's. We buy the clothes and shoes b/c SD comes to us (crying sometimes) that she doesn't have what she needs at Mom's house. Like now....the weather is getting warmer 80's-90's and she only has 1 pair of shorts that fit her at home. She said she asked her Mom lots of times for shorts and Mom says yes but never buys them. SD also frequently comes over in her little sisters underware. Sz 6/7 when she needs a Sz 14. So I go through this never ending cycle of throwing away stuff that is ill fitting and sending her home in new stuff. Or just buying her stuff to take over there.

Mom lives in a trailer with b/f and her own Mom helping to pay for expenses. Trailer is owned and lot rent is $450 a month. She gets over $1000 a month in CS plus has a full time job. She owns her car so no payment there. B/F owns his car.

Mom takes her vacations alone with her boyfriend and doesn't take the kids. The kids go on vacation 1x a year with her Dad. Usually camping.

SD also goes to camp each summer which we pay for.

So as you can see her actual out of pocket living expenses are minimal.

And she's trying to get away with paying even less by not covering her.


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RE: Are we being fair???

That's too bad that your Sd is in that situation. Honestly I think if you feel you are having to cover her too much, then you should stop providing for sd at mom's house. If she is getting over $1000 a month then she should be able to provide for her child. I don't give much thought into what she has, who is helping pay for what, how much rent is, what kind of car or if there is a payment, it doesn't matter. The fact is, there is an order, stick to it. Unless you want to go above and beyond what your obligations are, which I applaud you, remember in doing so without being forced to, it's a gift and you can't complain.
In my order, yes I provide health insurance BUT it states both parents are responsible for proving health insurance. Then it states parties agreed that BM covers, BD reimburses 1/2. If I drop for any reason, loss of employment, loss of benefits, loss of wages, BD has to pick up insurance. It doesn't state I have to reimburse. It also states that if either parent has access to health insurance via their employer, neither parent can put Dd on state health care plan. If a private policy can not be obtained at lower than 9% of the parents income, at that time, state insurance can be applied for. We wouldn't qualify but they do provide the option after all other options are exhausted.

I would ask her to reimburse. You can't force her since the order doesn't state. But ask and cross fingers. Don't demand. Explain the situation and the cost. Show the benefits of your plan, it's more affordable than any plan I have EVER had... So be sure and point out the good part about having her on this plan. Ask for 1/2. You can always ask OAG to modify for reimbursement. I think there was another thread about this.
If SD isn't being cared for properly, why not file for your Dh to have custodial rights? If she is in such poor conditions, then your Dh should do something to protect his child from what you describe as a neglectful home. If it's not worth filing for custodial rights to make sure his child is cared for and not neglected, then I don't see how anyone can complain about what is going on over there. I know it's frustrating to watch. $1000 is a LOT and when I was receiving over $1000 a month, it was covering a LOT and I was able to save a lot of it for expenses, college whatever. My honest opinion on health care though, not sure what state you are in but it's very uncommon for the ncp to NOT provide health care on top of child support plus 1/2 of out of pocket. So what you are having to do now is what all NCP's here are ordered to do period. My agreement was just that ' an agreement' not what was standard or ordered by the OAG. The OAG would not allow me to carry the insurance even though I asked to do so with NO reimbursement request. They said they could not ethically do that because the NCP's responsibility by the family code is to provide medical care and 20% of net income in support payments.

On OAG website for my state, information for non custodial parents.
Why do I have to pay medical support? I already pay child support.
Answer: medical support and child support are separate obligations the court may require of either parent or both. Family Code guidelines used for setting current child support assume the person paying support will also be paying for health insurance for the child. If the custodial parent is to provide health insurance coverage, the court will order you to pay additional support in the form of cash medical support.

The percentage child support is based on for 1 child is 20%. Health insurance should be less than 9% of your income. If the non custodial parent does not provide health insurance, the combined child support and medical support should equal no less than 29% of the non custodial parents net income.

So if you lived here, which I know you don't, you would be paying health care as part of your medical support obligation. And if she was providing it you would have to reimburse her 9% of his income. Not sure what his income is but is 9% less than $550 a year? I get $1200 a year for medical support... But I pay $3700 and some change give or take... I end up paying more than double what NCP reimburses but I'm just pleased he reimburses. Some more food for thought.


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RE: Are we being fair???

wow! over 1000 a month! DH must be making lots of money. i see now that BM is not spending much living with all this people and getting that much CS. hopefully you can make her to pay for medical expenses


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RE: Are we being fair???

LOL...she gets $500 from him for his child and $500 from another guy for her other child.

Myfam....how would medical support vs. CS work in our situation since NEITHER parents are providing ins.

I'm providing it......


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RE: Are we being fair???

I don't know girl, that's a tough situation as I don't see any law that states 'if stepparent provides'. They both should reimburse YOU. However, you and your DH are probably sharing finances so as you are providing insurance, it's as if DH is providing insurance. Or another way to look at it would be that what if DH had a private policy for his child, payment for private policy would come out of your shared income so in my opinion, you are both providing insurance. If you do not combine your incomes into one account and you are paying for insurance out of your income then I am inclined to say that both parents should be reimbursing you for the full amount of premiums since neither is providing for their child. I guess it depends on how you and DH do your finances.

As far as child support: remind me, does she work? Is child in daycare? $500 for 1 child is not a lot. $1000 for two is not a lot. $1000 for 1 is ALOT. I pay well over $1000 a month in childcare for two kids. I pay $800 a month on a 4 week month for one child. I pay $1000 a month for a five week month for one child. How do you know the other child's support is paid on time or at all? What if she is only receiving your Dh's $500 -- that won't support a lavish life style. Lol $1000 won't support a decent lifestyle either. So she would have to have help, welfare, benefits whatever to live. Yes she should be using some of the support for clothes and toothbrushes etc but what if she is the only one paying rent/food/gas/school expenses? I think being that all I ever have heard about where child support goes and what it is supposed to provide and how one isn't doing with it what they should, is why I ask all these questions. Child support is to provide shelter, food and heat. If any is left at the end of the day, then it can go to clothes, shoes etc. There is no way I could provide 100% for my Dd on $500 a month. Not in the way of what you are suggesting. Don't get me wrong, I might not be able to afford clothes so I shop at resale shops or target and there is the occasional name brand but not often... I do what I'm supposed to do and understand what you are saying. I'm just wondering how you know so much about ex's finances. No way would I allow my ex to know anything about my financial situation. He thinks he knows but I just let him look like an ass and think he knows everything because of what he sees on the outside.


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RE: Are we being fair???

oh I see, I thought she is getting 1000 from DH.

I do agree with myfamp here, 500 is very helpful yet it is not covering what a child needs at all. Even if they live with mom and BF who might be contributing, still 500 not enough to cover everything. And who knows even if she lives with BF, he might not be contributing and mom might not be buying anything.

I am a bit confused why mom has to pay all co-pay rather than a 1/2? I don't think you need to be the one paying premium and co-pays at all, mom and dad should split in half. I don't think CS includes health insurance. 500 a year in premiums is not that excessive. What does your layer say? I would go by what law says.


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RE: Are we being fair???

I just found out that next year we'll be paying minimum of $600 a month per single person and 1300 per family, that's just premium, there is still deductible and co-pay. I sat down and cried. My SO pays less premium but his deductible is $3000 per person, you might as well have no insurance at all and just have some emergency plan for a hospital. I think you guys lucky you have to pay only $500 a year for a child and just $75 in co-pays. That's one inexpensive health care.


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RE: Are we being fair???

That's got to be wrong but it may depend on who she works for. Our plan is pretty similar to what most friends/family pay. If Dh and I didn't work together or one of us work for a company that doesn't provide health insurance we would be paying $650 a month for the family. Since we are both covered as employees at no cost to us, we only have to cover dependents and it's much cheaper to cover a child than an adult.
Exdh used to have a private policy for Dd only. It was $75 or $100 a month. When the Obamacare was passed, insurance companies started denying 'children only' policies. So it's almost impossible to go out and get a child only policy anymore.

Jen- is what you pay SDs portion of premiums or is that it for everyone?

I think you are very kind to put her on your policy. It shows you care.


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RE: Are we being fair???

Myfam...the $500 year is what is xtra to add her to my exsiting policy.

His child support amount is based off of that fact that she's supposed to be covering the insurance. Currently he already pays over 20% of income in support.

NJ has a "calculation" that is used when determining child support. They plug in both parents income, living expenses, other assests, and then factor in other things such as if either have other children, who's covering health insurance, and how many nights per year the child is with each parent, among other things. So in our case there is no separate medical support as it's already factored into the amount of child support he pays. Because at the time she was the one covering the insurance.Each parent has to provide proof of income and expenses so that is how we mostly know she has basically nothing for bills compared to most households. With bank statements she could not hide the fact that b/f is helping with bills also.

So we know that he pays X amount in CS and that includes money for health insurance.

So he still pays X amount in CS and now is also covering health insurance.

So we think she should either pay us for the insurance and split 1/2 copays or just pay all co-oays.

She's not agreeing to either. She wants us to continue to pay for ins. and split co-pays. If we went back to court we could get our CS lowered based on the fact that the "calculation" would come out differently based on the fact that we're now covering ins. Also his income has dropped dramatically since he was laid off. Not to mention that fact that his living expenses have gone up as well and SD has been staying with us 8 nights a month instead of 6.

We don't want the support lowered. We just want her to cover what the courts deemed fair previously.

We know that the Grandma watches the kids for free since she lives there and BM has told us this. So she has no childcare expenses and she's not shy about chatting up DH all about her life :/ As long as I'm not around.....

Hopefully we can get something worked out. When SD was on BM's ins. she never took her for shots or dentist checkup or anything. She wouldn't give us the ins. info either so we could take her. So we'd like to keep her on my insurance so we at least know that she's getting all her checkups, shots and dental cleanings.


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RE: Are we being fair???

There are some very nice insurance plans, no premiums, minimum co-pay and no deductible. So I believe they might have such nice coverage. I used to have a decent one too, but those times are over. I don't have dependents any more, but I have to pay for myself 600 a month through my employer, if I still had DD on my plan I would have to pay 1300 a month, yeap. I used to buy private policy for DD and it was way cheaper. I agree it is nice of SM to have SD on her policy but they are also lucky they have such inexpensive plan. Otherwise I don't know how people could afford it? I don't know how I am going to afford mine.


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RE: Are we being fair???

I know!! It's so expensive!! And we always shell out thousands a year!! My husband has had kidney stones and sinus problems and it's soooo freaking expensive!!!

Well Jen that clears it up! I agree with you. 250%!


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RE: Are we being fair???

BM has to contribute something, whatever that something is, seems like she wants to contribute nothing or as little as possible.

Maybe it is irrelevant but if he pays 500 in CS and it is 20% of what he makes, then he really isn't making much money at all and can't just throw money around. Plus now he is laid off.


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RE: Are we being fair???

So we're definitly going to take her to court. Papers drawn up and getting filed tomorrow.

After reading opinions we are asking for:

BM to cover all co-pays up to $250 per year (1/2 of cost of coverage) and after that we will cover all dental and vision copays and she can cover all medical copays. This helps to protect us as we feel she's taken her for some medical reasons we think are ridiculous. Like having a pinkie toe xrayed for stubbing it on the bed. It wasn't even bruised. We'd rather not pay for 1/2 of any and all little thing she chooses to get. Nothing was wrong with the toe and if it was broken the course of treatment would have been the same anyway. Tape it up and move on! Not to mention the allergist she took her to and SD complained to us that BM was lying to the Dr. about symptoms that SD was not having or ever had. So, if we cover dental and vision we're kind of protected from that.

We're also asking for EOW to be extended to include Sunday nights.


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RE: Upcoming court date

DH filed a Notice of Motion and court date is Aug. 12th. She received papers on Saturday and no bad behavior yesterday or today. Not a peep out of her. She even let DH speak to his daughter on Monday (her birthday). In the years past she has never answered the phone on her bday. Easy drop off this morning with no argument or problems. Maybe she wants to mind her P's and Q's until the court date and our summer will actually go pretty smoothly??? I can only hope.


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RE: Are we being fair???

Good luck! Keep us updated.


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RE: Are we being fair???

Wow!! You girls think $500 for one kid is not much.... for my 16 year old I get $264/month. Ds11 I'm supposed to get $205/month but don't.... and ss my dh is supposes to get $224.... but shes not keeping it up. Id love to get $500 per month for all three of them. Plus I cover everyone on my insurance.

Good luck Jen!


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RE: Are we being fair???

No it's not a lot at all. That was the point. That includes health insurance .. So no it's not a lot but it just depends on the income


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RE: Are we being fair???

Thanks ladies. Yes the $500 he pays is not alot but it's over 20% of his income :(

I'm waiting to see if we get a Cross Motion in the mail. (Her response)

She has to have it in within 20 days of the court date.


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RE: Are we being fair???

Well our court date is tomorrow. In her cross motion she is asking to be able to take the health insurance back in February when she has open enrollment. We agreed as long as she covers medical/dental/vision (same as she has now) and provides us with copies of the medical cards.

Here's the kicker.....she's asking the courts to bar my DH from taking his daughter to any doctor/dentist unless it's an emergency situation. ????
She said that he "frequently" takes her to doctors/dentists without her knowledge or permission and then does not notify him of anything. Well......good thing I have every single email he sent her saved. Advising her of what dentist we were going to and when and another email that was sent afterwards advising the outcome. Unbelieveable. And he only took her to a medical dr. once at BM's request cause she didn't want to take a day off work. The gall of some people I swear.

I'll update the outcome after court tomorrow morning.


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RE: Are we being fair???

Good Luck tomorrow. And good luck to Bm if she thinks that he isn't going to be allowed to be an active role in the health care of his child!

That's nuts.


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RE: Are we being fair???

Results:

We did not get to have her with us Sunday overnight as part of our EOW.

We did however get:
The right to take her to the dr. or dentist
The right to hard copies of the medical/dental/vision cards when BM take health insurance back in Feb (her open enrollment)
BM covers ins. as well as 1st $250 in expenses. Everything else split 50/50.
BM has to give 24 hours notice before taking her to any dr.'s and provide us with written results.
They are now required to comminicate in writing.
BM has to reimburse for past 4 months of medical expenses we paid out.
We got extra time in the summer.
We did not have to pay her legal fees.

We still would have liked to only be responsible for dental/vision and not medical as he never agrees on the crazy tests she takes this child for without cause or symptoms. But I guess if we don't agree then we won't pay and she can take us to court and explain to the judge why she's taking a kid with NO symptoms to the allergist and subjecting her to tests and lying to the Dr. about the symptoms.


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RE: Are we being fair???

That all sounds pretty reasonable. Sunday evening overnight may perhaps be just as well as going home to BM's gives the child a chance to unwind from the weekend and get everything ready for school Monday morning. Not that she could not do 'that' at your house, but one can't get everything they ask for so might as well look at this item in a good light...you did get most everything else and additional summer.

You may have already stated as I did not go back and reread everything, but what is a co-pay amount each time the child goes to dr? Example, does BM pay premium of insurance and a set co-pay per visit or does she pay the premium , a deductible a yr and then something like 20/80 of actual bills as co-pay? Just curious, as I think how much is having to be paid per each visit after insurance pays their part is pertinent to opinions on sharing the remaining cost of spliting between the parents.


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