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FAQs about court-ordered dependent enrollments

 

When does a medical child support order become a qualified medical child support order?

The plan administrator must review the Medical Child Support Order (MCSO) document for the following information in order to make a qualification determination:

  • The name and last known address of the employee and dependent (the name and address of a state agency or official may be substituted for the address of the child).
  • The eligibility of the employee--employee need not be enrolled under the plan, but must be eligible to receive coverage, and must abide by the plan's waiting period where necessary.
  • A description of the type of health coverage required--an MCSO cannot require a company to provide coverage that is unavailable under its plan (e.g. vision coverage for the child, where the plan only offers medical and dental)
  • The duration of the order

Per the Department of Labor's guidance, the administrator has a "reasonable period of time" to make a qualification determination, inform the employee and dependents and initiate the coverage process.

However, if the order is a National Medical Support Notice, the administrator is required to abide by specific processing times, as set forth below and/or on the notice itself.

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