HMO dependent application

Hi to all!

I am a new member here and I would to seek a legal advise. I am currently working in a BPO company and I am already a regular employee. Being a regular employee I am entitled to an HMO provided by the company and per HR policy if we need to enrol our dependents we need to pay their premium.

I am a Solo Parent for a 12 year old girl who happened to be my neice, her mother who is my eldest sister, a single parent died with breast cancer way back 2003.

I enrolled her to HMO coverage as my dependent and filed my application to our HR last 8/25/2010.

On 9/7 I got an email from representative of HMO that my application has been denied because my dependent was considered as extended dependent, I replied with them that my dependent is not an extended but considered to be my direct dependen, and stated the RA 8972 known as Solo Parent's Welfare Act of 2000 and I provided them a copy of my Solo Parent Card issued by DSWD.

I followed up last week and they advise me that my application was already at their legal department and still re evaluating my case.

I would really appreciate someone to give me some legal advise what do I need to do to facilitate the approval of my HMO application. Is their a chance that my application will be denied? and on what ground?

Thank you so much,

Alberto



I would appre

This is a very interesting question. I do agree with you that the Solo Parents Act defines you as a solo parent, but did not change the definition of child to include your orphaned niece. in short, the you are solo parent of the child, but she is not your child

Coverage by the HMO is purely contractual and the definition of dependent is dependent on the definition established by the HMO. In my opinion, there is basis to deny your request.

Nevertheless, I hope you continue to assert your request that your niece should be considered your child for the purpose of defining her as a dependent. good luck!

I am doing this because I am solely responsible for her needs.. and I want to feel secure that I can provide her a Medical needs, if not I am still the one to burden the hospital expenses )in case she get sick). I can provide them some records like her School records, my SSS and others that she is my direct dependent or beneficiary. So the RA for Solo Parent would that enough that she can consider my direct dependent or my child?

But with my previous company that I worked with my application for her HMO was approved and I only executed an affidavit of Support.

for me, this is a contractual situation. it will all depend on the decision of the company and the HMO whether they will accept your to be covered. I assume you have given them all the documentary evidence such as your dswd ID and affidavit of support. does your company consider your niece as a dependent for the purpose of computing your income tax? argue that also.

ultimately, though, if push came to shove and you demanded in court that this be granted, I do not believe it would prosper. still, good luck.