If I get married will my employer provided medical insurance to cover my step-son?

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If I get married will my employer provided medical insurance to cover my step-son?

I work for Southern California Edison, I’m considering getting married again. Would my future wife’s 6 year old son be covered by my insurance (whether or not I adopt him)?

Asked on December 19, 2010 under Employment Labor Law, California

Answers:

M.D., Member, California and New York Bar / FreeAdvice Contributing Attorney

Answered 10 years ago | Contributor

In today's society “family” relationships can be very complex to define. Health insurers have not caught up with that complexity.  As a result, employer-provided health insurance does not always have to cover step-children, even though it will cover biological/adopted children. When someone pays for “family coverage,” that coverage was once based almost exclusively on a definition of “family” that only takes in legal relationships, such as those of blood, marriage, or adoption. 

Insurance is a contract.  This means that an insurer will negotiate the policy with an insured. However, the parties are not truly 100% free to contract as they choose, since states also pass laws to regulating insurance practices.  Since a step-child is not legally a child of the step-parent, the step-parent’s health insurance coverage does not, absent some specific contractual clause or state law, have to cover the step-child (any more than an employee’s health insurance has to cover the children of boyfriends, girlfriends, etc).  While he step-parent/step-child relationship has been recognized by society, there is actually not always legal force to it.  A relationship between 2 adults does not automatically create a legal relationship between 1 of those adults and the children of the other.  

Of course, if the step-parent also adopts the children of their spouse, that changes things. Legally, adoption is in all respects the same as a biological parent-child relationship. In the eyes of rthe law,  adopted children are the children of the adopting parent. After adoption, the children would be eligible for health insurance under the adoptive parent's plan. 

Note:  State laws may require insurance based on cohabitation, domestic partnerships, or even a common law marriage, or a court order.  It's important to seek professional legal advice about how a state's particular laws affect insurance rights and obligations between non-legally related individuals.  Speak to your HR department and see what they say.


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