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At the Law Office of Dustin S. McCrary, family law is our passion.  We spend each and every day working with families, and have the opportunity to see how much parents love their children on a daily basis.  Without question, most parents want to support their children in every way possible. When couples are still married, determining what expenditures to make on behalf of the children is usually a cooperative, joint decision.  Upon divorce, however, as child support obligations and responsibilities are determined, things can quickly and unfortunately become contentious. 

Fortunately, for many parents who are experiencing disagreement over child-related expenses, the law in North Carolina is fairly clear on how child support is calculated.  Some parents are able to come to an agreement on child support via a parenting agreement that they enter into with the advice of counsel, while others ultimately need a court to address the matter and enter a child support order.  In either case, Chapter 50 of the North Carolina General Statutes regulates child support, and provides detailed guidance not only on how to calculate a support obligation, but also details on who can bring an action, how soon a support case can be heard, and other important child support matters. 

Health Care Concerns

One critical component of child support, of course, concerns health and medical treatment for the couple’s children.  Access to good healthcare is of course essential to every child’s growth and well-being.  However, as most of us know, health care certainly isn’t cheap.  For this reason, it is important to address the issue of who will pay for health care as part of the child support determination. When determining which party will be responsible for providing health insurance for the children, the court will always assess the health care benefits provided by the parents’ place of employment first, and whether or not they have the ability to provide health care through that employment at a reasonable cost. 

It is important to note, however, that health insurance premiums are most often paid via the employer withholding the amount of the premium from the employee’s check. There are certain federal and state limitations that do apply to withholdings in the context of child support payments, and it is important to take this into account when addressing health care issues.  Legally, an employer cannot withhold more than 60% of an employee’s check for child support and health insurance premiums.  As a result, it the additional premium for health insurance which would be withheld pushes the total withholding amount over that threshold, the plan will not be required to extend coverage for the child, unless the employee-parent voluntarily consents to a greater withholding. Verifying whether this will be the case is therefore of great importance when assessing health care coverage responsibilities. 

What is a QMCSO?

When the court determines which parent will be responsible for providing health care, it will enter what is called a Qualified Medical Support Order, or QMCSO.  In essence, a QMCSO is a court order that is issued by the court in accordance with applicable federal and state laws, requiring the parent to provide either monetary support for the purchase of health insurance, or to enroll the child(ren) for coverage under his or her employee health care plan.  

A QMSCO specifically sets forth the right of the children to receive benefits under the employee parent’s group health plan, and importantly, this is the case even if the parent who is the primary custodian of the children is not actually the employee.  The QMSCO authorizes withholding the parent’s share of the cost of coverage from their pay, and also often provides that the parent may not drop coverage for the child(ren) without proof that the QMSCO is no longer in effect. 

In order to officially be considered a “qualified” order, the medical child support order must contain the following information:

  • The name and last known mailing address of the employee participant, as well as each alternate recipient (meaning the child(ren);
  • A reasonable description of the type of health care coverage to be provided;
  • And the time period to which the order applies.

A QMSCO may not require that a plan provide any options or benefits that are not normally provided by the plan, unless required by particular state laws. 

After the information has been submitted, the administrator of the plan will make the determination as to whether the order is qualified.  The administrator is generally required to make this determination within a reasonable amount of time, and must notify the parties of its decision. 

Why is a QMSCO Necessary?

A QMSCO is typically required as a matter of efficiency, in order to ensure that the administrator of the employee’s plan has sufficient information about the child(ren) and the participant-parent to complete the enrollment and implement the necessary benefits.  It is therefore important to provide thorough and correct information to the administrator to ensure that the plan can be implemented as easily and efficiently as possible, and take effect for the benefit of the child(ren) concerned. 

How Long Will a QMSCO Remain in Effect?

Typically, as long as all conditional requirements of the plan are met, and the employee-parent remains employed and eligible for coverage, the child(ren) will as well.  If, however, the parent-employee no longer remains employed at the business providing coverage, coverage for the child(ren) will end as well.  At that point, the parents will want to pursue COBRA coverage, or otherwise arrange to return to court as quickly as possible to determine an alternate support arrangement for health insurance purposes. In other instances, plans will cease to provide coverage for dependent children when the children reach the age of majority at 18, and in those instances, unless alternate arrangements are made, coverage will indeed terminate at that time. 

We’re Here to Help

Ultimately, the QMSCO is a very effective way to ensure that your children have the health insurance coverage that they need, when they need it.  Both parents and courts look at health care as an integral and vital part of a child’s well-being, and as a result, should continually work together to ensure that coverage is provided.  A healthy child is a happy child, and most parents want nothing less.  If you have any questions about child support, including the provision of health care coverage for your child(ren), or any other questions about the divorce process, at the Law Office of Dustin S. McCrary, we would welcome the opportunity to listen to your concerns, learn your story, and find out how we may be able to help you.  Call us today. 

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