My daughter is listed as my mother’s sole life insurance beneficiary, so why can’t I use the policy to pay for mother’s burial?

My wife and I are separated but not divorced. Is she still covered under my HMO?

Q: I am a city employee and my mother was a city retiree. Recently, I tried to use her life insurance to get a funeral assignment for her burial expenses. I was denied the funeral assignment, because my 17-year-old daughter, her granddaughter, is listed as her sole beneficiary. Why was this a problem?

A: The beneficiary designation was given to someone who is under 18 and considered a minor in Texas. Minors can be named as beneficiaries; however, minors cannot receive payment of the proceeds. Also, proceeds payable to a minor cannot be used for funeral expenses. Your daughter cannot receive payment until she turns 18 or the insurance company receives legal documentation showing a financial guardian for her.

Beneficiary designations can be updated by requesting a new beneficiary designation form from the benefits office, (713) 837-09400 or by visiting the benefits office, 611 Walker, 4th floor.

Because your records are confidential and protected, a written request, a written release with your notarized signature, or your physical presence is required to get any information from your benefits file.

Q: My wife and I are separated, but not divorced. Is she still covered under my HMO? Am I responsible for her medical bills? I am living in Houston and she is in Florida.

A: As long as you are married and the plan rules are followed, your spouse’s health-care services are covered under the HMO until she is dropped from your policy or is no longer your spouse.

Health care services:

• must be medically necessary,
• provided within the HMO covered services areas, 34 counties in Texas only, and
• provided by the PCP or authorized by the PCP unless emergency care is needed within 12 hours after the onset of an illness or within 48 hours after an accident.

If you want to drop your wife from coverage, and you pay premiums with pretax dollars, your spouse can be dropped only if you are divorced, your spouse becomes employed and enrolls in that employer’s benefits program or your spouse dies. You may also drop her during open enrollment with supporting documentation.

If you pay your premiums with post-tax dollars, you may drop your spouse any time during the year. Just complete a medical change form and return it to your human resources liaison.

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Pulse readers can get answers to their medical, dental and insurance benefits questions from the Human Resources Benefits Division's customer service representatives. Veronica Rodriguez answers your questions in this issue.

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