Group health plans subject to ERISA must extend health coverage to the children of a parent-employee who is divorced, separated, or never married when required by a properly-issued court order. All ERISA plans must have procedures in place for determining if such an order is a qualified medical child support order (QMCSO) and must be followed. These procedures must be distributed upon receipt of an order and upon request. Additionally, a state child support enforcement agency may obtain employer-provided health coverage for a child by issuing a National Medical Support Notice that the health plan determines to be qualified.
A QMCSO generally directs an employee to cover his or her child under the health plan. If the order meets certain requirements, which must be documented in the plan's QMCSO procedures, the employer must enroll the child for coverage. In some circumstances, the plan can require the employee to enroll for coverage in order to enroll the child.
A plan must have procedures in place for evaluating domestic relations orders. To be considered "qualified," the order must meet certain legal requirements. The plan must make the determination about the order's qualification within a reasonable period of time. The plan has to notify both the participant and the child when the order is received, and must give them copies of the plan's QMCSO procedures. The plan is required to notify those parties of its determination on the order's status whether or not the order is considered qualified.
BAS can draft QMCSO procedures for your organization and can evaluate orders you receive. Through MyEnroll.com, BAS can communicate with affected parties and store a PDF of each communication against a participant's MyEnroll.com private account. These PDFs will be accessible to your administrators and the employee 24/7. For more information, please contact sales@BASusa.com.
