Page 54 - HarborLight CU 2014-15 SPD
P. 54
• Review the order to determine if it qualifies as a QMCSO.
Use the checklist attached to these procedures to determine whether the order qualifies.
Upon receipt of a notice that purports to be an NMSN, the plan administrator must:
• notify the state agency whether coverage for the child is available under the plan;
• if so, indicate whether such child is covered under the plan and the effective date
of coverage or the steps necessary to effectuate coverage;
• provide a description of the coverage; and
• provide the forms necessary to effectuate the coverage.
Follow the instructions specified in the notice to determine whether the notice qualifies and
to provide an appropriate response to the agency.
Notice of determination. Within a reasonable time after receipt of the order (not more than
40 days), the plan administrator must notify the participant and alternate recipient that
either:
• the order is a valid QMCSO; or
• the order is not a valid QMCSO (including an explanation of what provisions are
defective or missing).
Legal issues. Any disputes raised by the parties should be referred to the plan's legal
counsel.
Resubmitted orders. If an order is found to be invalid, the parties may "cure" the
deficiencies with a subsequent order. If an amended order is submitted, the evaluation
process is re-initiated for the new order.
Administration of qualified orders.
Administrative guidelines.
The checklist attached to these procedures includes a list of the provisions that
must be included for the order to be considered a QMCSO. In addition, there are
several items of information that are needed to effectively administer the QMCSO
and enroll the alternate recipient child under the plan. This information includes:
A record of any the individual or of a state or political subdivision who is designated
as the alternate recipient child's representative (e.g., the child's custodial parent or
legal guardian). Copies of all correspondence relating to the alternate recipient child
should be provided to the participant, the alternate recipient child and any designated
representative, with due regard to privacy of the individuals involved.
A completed election form.
Employee authorization for payroll withholding of applicable premium. If coverage
under the plan is provided on a pre-tax basis through a section 125 cafeteria plan,
the QMCSO may, depending on the cafeteria plan's terms, qualify as an acceptable
"change in status event" under the cafeteria plan. The cafeteria plan document
should be reviewed to determine if the definition of "change in status" is written
broadly enough to allow for such election changes.
In addition, a QMCSO may provide that someone other than the employee will be
making premium payments for the alternate recipient child's coverage. If the order
49
Use the checklist attached to these procedures to determine whether the order qualifies.
Upon receipt of a notice that purports to be an NMSN, the plan administrator must:
• notify the state agency whether coverage for the child is available under the plan;
• if so, indicate whether such child is covered under the plan and the effective date
of coverage or the steps necessary to effectuate coverage;
• provide a description of the coverage; and
• provide the forms necessary to effectuate the coverage.
Follow the instructions specified in the notice to determine whether the notice qualifies and
to provide an appropriate response to the agency.
Notice of determination. Within a reasonable time after receipt of the order (not more than
40 days), the plan administrator must notify the participant and alternate recipient that
either:
• the order is a valid QMCSO; or
• the order is not a valid QMCSO (including an explanation of what provisions are
defective or missing).
Legal issues. Any disputes raised by the parties should be referred to the plan's legal
counsel.
Resubmitted orders. If an order is found to be invalid, the parties may "cure" the
deficiencies with a subsequent order. If an amended order is submitted, the evaluation
process is re-initiated for the new order.
Administration of qualified orders.
Administrative guidelines.
The checklist attached to these procedures includes a list of the provisions that
must be included for the order to be considered a QMCSO. In addition, there are
several items of information that are needed to effectively administer the QMCSO
and enroll the alternate recipient child under the plan. This information includes:
A record of any the individual or of a state or political subdivision who is designated
as the alternate recipient child's representative (e.g., the child's custodial parent or
legal guardian). Copies of all correspondence relating to the alternate recipient child
should be provided to the participant, the alternate recipient child and any designated
representative, with due regard to privacy of the individuals involved.
A completed election form.
Employee authorization for payroll withholding of applicable premium. If coverage
under the plan is provided on a pre-tax basis through a section 125 cafeteria plan,
the QMCSO may, depending on the cafeteria plan's terms, qualify as an acceptable
"change in status event" under the cafeteria plan. The cafeteria plan document
should be reviewed to determine if the definition of "change in status" is written
broadly enough to allow for such election changes.
In addition, a QMCSO may provide that someone other than the employee will be
making premium payments for the alternate recipient child's coverage. If the order
49
