Page 56 - HarborLight CU 2014-15 SPD
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Checklist for Determining the Validity of Order
(QMCSO Procedures Attachment #1)
Section 609(a) of ERISA requires group health plans to honor the terms of a Qualified
Medical Child Support Order (“QMCSO”). The determination as to whether a particular child
support order is “qualified” is made by the plan administrator. This checklist will help determine
whether a particular order qualifies under section 609(a) of ERISA.
This checklist sets out the items that must be present for a child support or other court
order to be a QMCSO. The plan administrator should complete this checklist as soon as
possible after receiving such an order. If all items are present, the parties shall be notified that
the order is a QMCSO. If one or more items are not present, the parties shall be notified that the
order is not a valid QMCSO.
Complete a separate checklist for each plan governed by the terms of the order.
The term “you” or “your” in this checklist refers to the plan administrator.
1. Is the document a child support order?
The order must be a judgment, order or decree (including approval of a divorce
settlement agreement) related to child support, alimony, or the division of marital property,
issued pursuant to state law (including certain state Medicaid laws). Agreements made by the
parties but not formally approved by a court are not acceptable. The order may also be a
judgment, decree, or order issued through an administrative process established under State
law and has the force and effect of law under applicable state law.
The order may also be a properly completed National Medical Support Notice (“NMSN”).
If the order is an NMSN, the instructions specified in the notice should be followed in evaluating
whether the order qualifies and for providing an appropriate response to the agency.
A NOTE ON REVISED ORDERS: If an order was initially found to be non-qualified, and
the deficiencies are later corrected by the parties, the order may be resubmitted to the plan. In
this case, the corrected order must be approved again by the court or administrative agency in
order for it to be qualified.
2. If the document is a national medical support notice, does it include the
following?
An properly-completed NMSN will automatically qualify as a QMCSO because the form
is established by government regulations. In general, this form must include:
The applicable state law provisions that require the employer to withhold any employee
contributions necessary under the plan for the child’s coverage,
The duration of the required withholding,
Limits under the Consumer Credit Protection Act,
State law priority rules regarding amounts to be withheld for cash support versus health
plan contributions, and
The name of the state agency contact regarding the notice.
3. Does the order include all necessary names and addresses?
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(QMCSO Procedures Attachment #1)
Section 609(a) of ERISA requires group health plans to honor the terms of a Qualified
Medical Child Support Order (“QMCSO”). The determination as to whether a particular child
support order is “qualified” is made by the plan administrator. This checklist will help determine
whether a particular order qualifies under section 609(a) of ERISA.
This checklist sets out the items that must be present for a child support or other court
order to be a QMCSO. The plan administrator should complete this checklist as soon as
possible after receiving such an order. If all items are present, the parties shall be notified that
the order is a QMCSO. If one or more items are not present, the parties shall be notified that the
order is not a valid QMCSO.
Complete a separate checklist for each plan governed by the terms of the order.
The term “you” or “your” in this checklist refers to the plan administrator.
1. Is the document a child support order?
The order must be a judgment, order or decree (including approval of a divorce
settlement agreement) related to child support, alimony, or the division of marital property,
issued pursuant to state law (including certain state Medicaid laws). Agreements made by the
parties but not formally approved by a court are not acceptable. The order may also be a
judgment, decree, or order issued through an administrative process established under State
law and has the force and effect of law under applicable state law.
The order may also be a properly completed National Medical Support Notice (“NMSN”).
If the order is an NMSN, the instructions specified in the notice should be followed in evaluating
whether the order qualifies and for providing an appropriate response to the agency.
A NOTE ON REVISED ORDERS: If an order was initially found to be non-qualified, and
the deficiencies are later corrected by the parties, the order may be resubmitted to the plan. In
this case, the corrected order must be approved again by the court or administrative agency in
order for it to be qualified.
2. If the document is a national medical support notice, does it include the
following?
An properly-completed NMSN will automatically qualify as a QMCSO because the form
is established by government regulations. In general, this form must include:
The applicable state law provisions that require the employer to withhold any employee
contributions necessary under the plan for the child’s coverage,
The duration of the required withholding,
Limits under the Consumer Credit Protection Act,
State law priority rules regarding amounts to be withheld for cash support versus health
plan contributions, and
The name of the state agency contact regarding the notice.
3. Does the order include all necessary names and addresses?
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