Articles Posted in Health Insurance

Many parents worry about paying for the children’s medical expenses after divorce. If you have a final decree or custody order there should be provisions that detail how the children’s medical expenses will be split among the parents. Typically, one parent is ordered to maintain or obtain health insurance coverage for the children, the other parent might be ordered to pay all or half of the premium (depending upon the custody and visitation arrangement) and then the parties are ordered to pay 50/50 of the unreimbursed or uninsured medical expenses. Most likely, the parent who receives the bill of the medical expenses is ordered to send the actual bill to the other parent within 30 days of receiving the bill. Then, that parent has 30 days from receipt to reimburse the paying parent for their 50% of the expense. The problem arises in that most parties either do not realize or do not comply with the time limitations in the orders. So, what does that mean? If you have received a medical bill and failed to send it to the other parent within 30 days, does that mean that you have to count your losses on the medical expenses?

The Dallas Fifth District Court of Appeals answered this issue recently on an appeal from a Collin County case in In the Interest of I.O.K., J.C.K., and M.O.K., Children. In that case, the parties were divorced and subsequent to that, the mother filed an enforcement seeking reimbursement of medical expenses on the children’s psychology bills. The father failed to pay. The parties’ agreed decree stated, in part, that the party receiving the medical bill must send “all forms, including explanation of benefits (EOB), receipts, bills, and statements reflecting the uninsured portion of the health-care expenses within 30 days after” the party receives them. The father argued that mother never did this and so he should not have to pay. This is despite the fact that he knew the children were attending sessions with the psychologist and had received the bills in the discovery that the parties completed. The father was even receiving the bills from the insurance company with the EOBs. However, at the final hearing the mother admitted that she never sent the bills directly to father within 30 days of receiving them.

Based upon these facts and the reviewed testimony, the Court of Appeals agreed with father that his obligation to reimburse mother his portion of the unreimbursed medical expenses does not arise until mother complies with the terms of the decree and sends the bills to father within 30 days of receiving them. Mother even admitted this in her testimony. Therefore, the Court of Appeals held that you cannot hold the father responsible for the unreimbursed medical expenses when mother did not comply with her obligation under the decree. Therefore, they reversed the trial court’s ruling and ordered that mother take nothing.

You are a parent who has primary possession of the children and you need financial assistance from the other parent but they are not willing to help out by agreement alone. You realize you are going to have to take additional measures to get anything out of them; more specifically, you visit with an attorney and understand that it is going to take a court order.

Regardless of whether your case is a divorce or suit affecting the parent-child relationship, you will need to include a request for child support within your pleadings. This ensures that you have noticed the other parent that you are seeking this in court and it ensures that you can bring this issue up at the hearing. If your case is just beginning, this issue would be addressed at a temporary orders hearing. You and your attorney will put on evidence of the monthly net resources of the other party. How do you do that if you do not know what the other party is making? Your attorney at Guest & Gray will ensure that the party is noticed and ordered to appear with their financial records so that the judge and/or your attorney can calculate the correct amount of child support. However, if the other party ignores the court order and does not bring their financial records, typically the judge will be agitated with this and start asking the party questions on the stand about their financial information.

Once the monthly net is determined, child support is calculated based upon a percentage amount determined by the number of children involved in the suit as well as other factors. For instance, if you have one child child support would be 20% of the obligor parent’s monthly net resources. If the obligor parent has one other child that they are responsible for (remarries or has another child with another person) lowers the percentage down to 17.5% and then gets lower depending upon the number of additional children outside of your case.

You have a final family order, whether it is an order in suit affecting the parent-child relationship, final decree of divorce, etc., and you would like it modified.  You are either the parent receiving child support and you want the amount increased or you are the parent paying child support and you want it decreased.  Or, there has been a change that would require the conservatorship or visitation modified.  It is not an uncommon question and the Texas Family Code does specify particular deadlines and requirements with respect to filing a modification.

For child support, Texas Family Code Section 156.401 states that final orders can be modified if either (a) there has been a material and substantial change in circumstances for a party or the child after the order was entered; or (b) it has been three years since the order was last entered or modified AND the monthly amount either differs by 20% or $100 from the amount that it should be under the child support guidelines.  So, it has been less than three years but something has happened that would require a change in child support then you can seek a modification.  For instance, did the parent paying child support get a new job after your orders were rendered and they are now making more money?  Or, did the obligor lose their job and they are no longer making any money?  Additional instances of material and substantial change in circumstances would also be (a) the obligor parent had another child that they are financially responsible for; (b) health insurance has changed (lost or new premiums); or (c) the children are now living with the obligor parent or another person.

That brings us to modifying orders as to conservatorship and/or possession or access.   If you are seeking to modify the parent who has the exclusive right to designate the primary residence of the child in less than one year from the orders being rendered, Texas Family Code Section 156.102 governs.  If you do so, you must attach an affidavit to your pleadings and the affidavit must allege specific facts that the child’s present environment may endanger the child’s physical health or significantly impair their emotional development.  Not only must these allegations be made, but you also have to prove this.  If you do not have this, you will have to wait more than one year to change who has the exclusive right to designate the child’s primary residence.  If you are modifying in more than a year, your burden is a material and substantial change in circumstances of a party or the child AND it must be in the best interest of the child.  In fact, best interest of the child is the ultimate burden in every family law case.

You are a father who wants to be a good dad and support his child without breaking the bank and not being able to support yourself.  You do need financial resources in order to do this and you will probably pay guideline support. Our firm can help you.

How Much Will I Pay in Child Support?

          Some fathers fall into the trap of paying above-guideline child support.  That is, they agree to pay more than they are required either in amount of child support or they pay support and in addition to that pay for extracurricular, daycare, etc.  Texas Family Code 154.125 provides the chart on child support guidelines and it is as follows: