Limited Coverage

[Guest cosmo01]

We have a situation where an employee's child has had a baby and wants to add the grandchild to her health insurance stating that she has limited custody of the baby. Has anybody dealt with this before?

[oriecat]

How does your contract define eligible dependent? Have you seen any legal documents that prove any amount of legal custody?

[Guest cosmo01]

The plan defines a dependent to include "a natural, adopted, foster, or step-child of an eligible employer; or a child for whom an eligible employee can s how legal documentation issued by a proper court, of custory of guardianship; and who is single; and who is financially dependent upon the employee." The form that is filled out merely request guardianship for school registration and medical insurance coverage only. It is a fill-in the blank form that is submitted to the court for signature. I just have never seen this before. Based on this, theoretically, I could fill this out for my grandchildren or great niece of great nephew and get the judge to sign it and cover them?

[Sandra Pearce]

Many times a parent gives physical custody of a child to a family member in order to allow the child to go to a particular school and along with physical custody authorizes the family member to direct any medical treatment during the period of physical custody. That type of custody would not make the child an eligible dependent in our health plan. Our plan document includes in dependent eligibility "grandchild, child subject to the Employee’s (or spouse’s) legal guardianship." We would only allow this person to be added if the employee had legal guardianship of the child. In cases where we have been unsure of the documentation we have requested the advice of legal counsel.