When the enforcing agency serves a medical support notice on an employer:
(1) The employer shall comply with the provisions in the medical support notice;
(2) The plan administrator and the employer shall treat the medical support notice as an application by the enforcing agency for health care coverage for the named child under the health benefit plan to the extent an application is required by the plan;
(3) If the providing party named in the medical support notice is not an employee of the employer, or if a health benefit plan is not offered or available to the providing party, the employer shall notify the enforcing agency within 20 business days after the date of the medical support notice;
(4) If a health benefit plan is offered or available to the providing party, the employer shall send the plan administrator’s portion of the notice to each appropriate plan administrator within 20 business days after the date of the medical support notice;
(5) Within 40 business days after the date of the medical support notice, the plan administrator shall do all of the following as directed by the notice:
(a) Complete the appropriate portion of the notice and return the portion to the enforcing agency;
(b) If the child is or will be enrolled, notify the parties and furnish the obligee with the information necessary to effectuate coverage and submit claims for benefits;
(c) If the child has been or will be enrolled, provide the enforcing agency with the type of health benefit plan under which the child has been or will be enrolled, including whether dental, optical, office visits and prescription drugs are covered services;
(d) If more than one health benefit plan is available to the providing party and the providing party is not enrolled, forward the health benefit plan descriptions and documents to the enforcing agency;
(e) If the providing party is subject to a waiting period that expires more than 90 days after the date of receipt of the medical support notice by the plan administrator or if the providing party has not completed a waiting period that is measured in a manner other than the passage of time, notify the employer, the enforcing agency and the parties; and
(f) Upon completion of the enrollment, notify the employer of the enrollment;
(6) If the plan administrator notifies the employer that the providing party is subject to a waiting period that expires more than 90 days after the date of receipt of the medical support notice by the plan administrator or that the providing party is subject to a waiting period that is measured in a manner other than the passage of time, the employer shall, when the providing party becomes eligible to enroll in the plan, notify the plan administrator that the medical support notice requires that the child named in the notice be enrolled in the plan; and
(7) The plan administrator shall enroll the child and, if necessary to the enrollment of the child, enroll the providing party in the plan as provided by rules adopted by the Department of Justice. [2003 c.637 §6; 2007 c.878 §9]
Section: Previous 25.317 25.318 25.320 25.321 25.323 25.325 25.327 25.329 25.330 25.331 25.333 25.335 25.337 25.339 25.340 NextLast modified: August 7, 2008