§236.8. Medical support orders; health insurance enforcement

A. When a court orders a parent to provide medical support for the child, specifically requiring the parent to enroll or maintain the child in a health insurance program, the Department of Children and Family Services, in any case in which the department is rendering services, shall enforce the court order through the use of the National Medical Support Notice, regarding group health plans that are covered under the provisions of 42 U.S.C. §666(a)(19), 29 U.S.C. §1169, and 45 CFR §303.32, and shall serve on the parent's employer the National Medical Support Notice to enroll the child and employee in the employee's health insurance program in accordance with the medical support order.

B.(1) Unless a court order provides for alternative coverage, in any case in which a parent is required to provide health care coverage and the employer of the parent is known, the following procedure shall be complied with:

(a) The department shall use the National Medical Support Notice to transfer notice of the provisions for the health care coverage of the child to the employer.

(b) Within twenty business days after the date of the National Medical Support Notice, the employer is required to transfer the plan administrator portion of the notice to the appropriate plan providing health care coverage for which the child is eligible.

(c) In any case in which the parent is a newly hired employee entered in the State Directory of New Hires pursuant to 42 U.S.C. §653a(e) and R.S. 46:236.14, the department shall provide the National Medical Support Notice and an income withholding notice issued pursuant to 42 U.S.C. §666(b) and R.S. 46:236.3, within two days after the date the employee is entered into the directory.

(d) Employers shall withhold any obligation of the employee necessary for coverage of the child or children and employee and forward the amount withheld directly to the plan.

(e) If the employment of the parent is terminated and the employer has received a National Medical Support Notice, the employer is required to notify the department of the termination pursuant to R.S. 46:236.3(G).

(f) When a plan administrator reports that more than one option is available under the plan, the department shall promptly select a plan from the available options.

(2) An employer shall not refuse to employ, take disciplinary action, or terminate an employee due to medical child support withholding or the failure to withhold or transmit income to the applicable plan as the National Medical Support Notice directs.

C. Any liability of the parent to the plan regarding required employee contributions for enrollment of the child is effectively subject to enforcement unless the parent contests the enforcement based on a mistake of fact.

D. Upon request by the department, the employer may, without liability to the parent, provide the department with the name of the insurer and the parent's insurance policy number. The employer shall notify the department of any changes or lapses in health insurance coverage after a National Medical Support Notice to enroll the child and employee has been served.

E. The signature of the parent who rendered payment for service for the child is a valid authorization to the insurer for purposes of processing an insurance reimbursement claim and for payment to the provider of services.

F. The department may serve on all present and future employers of the parent the National Medical Support Notice to enroll the child and employee without having to amend the medical support order.

G. When a court orders a parent who is a participant or is eligible to participate in a group health plan to enroll or maintain a minor child in a health insurance program, the insurance company or health maintenance organization shall:

(1) Allow that parent to enroll in family coverage and include the child in the enrollment during the enrollment season.

(2) Allow the child's other parent, the department, or the Louisiana Department of Health for the Medicaid program to enroll the child and the employee without regard to any enrollment season restrictions.

(3) Continue the enrollment and the coverage of the child and the employee until the employee or the child is no longer eligible under the policy, or, if earlier, unless the employee provides written proof that the court order is no longer in effect or that the child has been enrolled or will be enrolled in comparable health insurance coverage, with the new coverage to take effect no later than the effective date of disenrollment.

(4) Not deny enrollment of a child under a parent's health insurance coverage on the grounds the child was born out of wedlock, is not claimed as a dependent on the parent's federal income tax return, provided the parent provides other satisfactory proof of dependency, or does not reside with the parent or in the insurer's service area.

(5) Allow the provider, the Louisiana Department of Health for the Medicaid Plan, or the Department of Children and Family Services to submit claims for covered services without the approval of the custodial or the noncustodial parent.

(6) Reimburse the parent who rendered payment for services for the child, the provider, the Louisiana Department of Health for the Medicaid Plan, or the Department of Children and Family Services directly for claims submitted by them.

H. An employer who complies with the National Medical Support Notice in accordance with this Section is not subject to civil liability to any individual or entity regarding the withholding of necessary contributions from the employee's income for coverage of the child or children and employee under the plan.

Acts 1992, No. 869, §1; Acts 1995, No. 707, §1; Acts 1997, No. 1155, §5; Acts 2002, 1st Ex. Sess., No. 115, §2, eff. April 18, 2002; Acts 2003, No. 618, §1, eff. June 27, 2003; Acts 2006, No. 481, §2, eff. October 1, 2006.