What should an employer do with a medical support order?

Must child medical care be withheld from an employee's earnings? Federal regulations require that states include medical support as part of any child support order whenever child health care coverage is available to the parent at a reasonable cost. Employers must permit enrollment in their group health care plan for of a child who is the subject of a child support order without regard to regular enrollment periods. In addition, coverage may not be cancelled for the child, unless there is proof that the medical support order is no longer in effect or that alternative coverage is being substituted. Finally, the employer must withhold the amount of any premium that the employee pays for the coverage from the employee's wages.

The order to withhold may require the employer to enroll the employee's child into the employer's health insurance plan. Upon receiving an order requiring coverage of an employee's child, an employer or health plan administrator must:

• Permit enrollment at any time under employer-sponsored group health coverage of any employee's child who is the subject of a child support order;

• Permit disenrollment only upon proof that the order is no longer in effect or that alternative coverage will be substituted; and

• Withhold any employee share of premiums from the employee's pay.

In addition, public IV-D orders enforced by a state agency must include a provision for health insurance coverage for the child. If the noncustodial parent provides this coverage through an employer-provided plan and changes jobs, the state agency must transfer notice of the health care provision to the new employer. If the new employer maintains a health plan, this notice will serve to enroll the child in that plan.

National Medical Support Notice. The federal Office of Child Support Enforcement has issued final regulations containing the National Medical Support Notice. The Notice is in two parts, one for the employer and one for the plan administrator. Part A of the notice is used to inform employers that they are required to withhold contributions for medical coverage from the earnings of the plan participant. The employer sends Part B of the notice to the plan administrator to inform the administrator that a plan participant is under order to provide medical coverage to an alternative recipient.

For state-specific information, see State Laws. For additional information on medical support orders, see ¶42,070 .