Qualified medical child support orders
The Department of Labor regulations require that we disclose our plans' procedures in regard to Qualified Medical Child Support Orders (QMCSOs) to members. Information regarding QMCSOs is included in your Group Agreement. These regulations went into effect for group health plans in 2003.
Priority Health's "standard" language regarding QMCSOs is:
A Qualified Medical Child Support Order (QMCSO) is a court or administrative order that requires you to provide coverage for a child in accordance with the law. A child will be enrolled in the plan under a QMCSO if you provide us with a copy of the QMCSO and the child is otherwise eligible for coverage as a dependent under the plan. If we receive a copy of the QMSCO but you do not enroll the child for coverage, the child may be enrolled by the Friend of the Court or by the child's other parent through the Friend of the Court. The child will be enrolled without regard to enrollment season restrictions. If the employee/parent isn't currently enrolled in the health plan, both the parent and child will be enrolled.
Coverage for a child enrolled under the plan by a QMCSO will not be terminated unless required contributions are not made as required by the plan; or we receive written proof that the QMCSO is no longer in effect; or we receive written proof that the child has or will have comparable coverage beginning on or before this plan's coverage is terminated; or the child no longer meets eligibility requirements of the plan.
Get a copy of our QMCSO procedure free of charge by
calling Customer Service.
