what happens if you list boyfriend as spouse for health insurance?

Question

I have a friend who lied on her application to get insurance for her boyfriend.

Answer 1

I've worked on dependent audits for several large employers...its a growing trend for employers to audit the dependents being claimed by their employees, and everyone should be prepared for that possibility.

When/if she gets audited, she'll be requested to provide proof of marital status (marriage certificates, tax returns, etc). If she can't provide the info, best case scenario is that he'll just be removed from the plan through the audit.

Worst case scenario is that the employer removes him *and* decides to penalize her. Some companies make the employees repay any medical expenses incurred by the ineligible dependent and/or go back and pay COBRA-equivalent premiums for the time he was covered. They could also choose to fire her, in addition to collecting all that money back from her.

Its not worth it - the odds are good that she'll get caught, and then they'll both be screwed.

Answer 2

Aside from the fact that it is fraud to misrepresent her boyfriend as her spouse her real problem is the fact that if her boyfriend ends up with a serious illness that incurs significant costs the health insurance company could request documentation of their marital status.

As they are not married there will be no coverage. So while she might be able to sneak by with getting a doctor's visit covered because no one's aware of the true situation in the event of a large hospital bill they would be responsible for the payment. That could be a catastrophic financial set back leading ultimately to bankruptcy.

By the way what does she do if she breaks up and gets a new boyfriend ;)

Answer 3

Well, if/when the policy gets audited, and she's asked to show proof of the marriage and can't, they'll cancel his coverage, and SHE will be responsible for any bills the insurance company has paid.

It's also insurance fraud - illegal, and punishable by a fine and jail time that varies by state.

Answer 4

That would be insurance fraud, and insurance companies will prosecute, and they will show no mercy.
She might get a letter, saying, " due to new requirements by our insurer, all who have spouses or children covered by this plan, must present a copy of the birth certifcate or marraige license, so we can update our records..........."
What will she do then??

Answer 5

Yep, fraudulent and a terrible idea. Especially considering some companies will write couples who are not married, but are living together.

Answer 6

Do not do it, as you will get caught at some point, have to repay all bills, plus interest and penalty, and then find yourself praying that you won't be charged with fraud.