Section 8.10 Health Insurance

• Library: Family Law Deskbook and 2014 Supp

D. (§8.10) Health Insurance

1. Insurance Coverage: Parent A will maintain health, dental, and vision insurance on the children through _________________.

2. Noncovered Costs:

a. The health benefit plan coverage described above does not pay all of the children’s medical, dental, orthodontic, optical, and other health care expenses. Parent B and Parent A have the financial resources to pay the costs of health care for the children not covered by the health benefit plan. Parent B should pay _____ percent and Parent A should pay ______ percent of the cost, expense, or charges for all medical, dental, orthodontic, endodontic, prescription, optical, psychiatric, psychological, nursing, counseling, and other health care expenses incurred by or on behalf of the children to the extent that the “medical costs” are actually incurred and are not fully covered, not fully paid, or not reimbursed by the health benefit plan.

b. Each parent will be ordered to comply with the health benefit plan in using health care providers and to timely submit claim information to the health benefit plan. If a parent fails to comply with the policy requirements and this results in an additional unpaid cost, that parent will be required to pay all of the additional costs attributable to the failure to comply.

3. Mechanism for Paying Costs of Noncovered Care:

a. A parent obtaining the noncovered care will provide a copy of each bill to the other parent and submit covered expenses to the insurer for payment. If a co-payment is required at the time of service, the parent will keep the receipt for the co-pay amount.

b. That parent should also send the other parent a copy of the insurer’s Explanation of Benefits showing the amount paid or denied. Within
30 days of receipt of the Explanation of Benefits, each parent must pay his or her share of the amount owed to the medical provider and reimburse the other parent the appropriate portion of the...