Medical Support Orders:
Oklahoma law requires that all child support orders contain meaningful medical support orders. Medical support is calculated in the child support computation and becomes part of the monthly child support amount.
Medical Support is:
1) Health insurance
- if accessible to child's needs, provider is within 60 miles of residence and available to either parent;
- other group plan or spouse at reasonable cost of 5% of gross income of parent ordered to cover the child;
- see federal requirements (Link opens in new window) 45 C.F.R. §303.31 and state law 43 O.S. §118F.
2) Alternative coverage
- including Military Defense Enrollment Eligibility Reporting System (DEERS) and Indian Health Services.
3) Cash medical support
- when health insurance doesn't meet the requirements listed above;
- does not have to exceed 5% of the parent ordered gross income;
- is assigned to the Oklahoma Health Care Authority (OHCA) when child is on SoonerCare; and is computed according to the Oklahoma cash medical income guidelines table.
Medical Support Enforcement:
Oklahoma Child Support Services is required to enforce child support orders with medical support for all children who are included in their open cases.
If health insurance is available through an employment-related group health plan, the employer and insurer are required by federal and state law and regulations Social Security Act §466(a)(19) (Link opens in new window), 45 C.F.R. §303.32, 36 O.S. §6058A (Link opens in new window), and 43 O.S. §118.2 (Link opens in new window) to permit the parent ordered to cover the child to enroll a child who is otherwise eligible for the coverage without regard to any enrollment season restrictions.
Oklahoma Child Support Services issues the National Medical Support Notice to employers and insurers to inform them of their responsibilities. Oklahoma law 36 O.S. §6058A (Link opens in new window), and 43 O.S. §118.2 (Link opens in new window) provides for sanctions against employers and insurers who fail to comply with the Child Support Enforcement National Medical Support Notice.
In addition, under 45 C.F.R. §303.30 (Link opens in new window), Oklahoma Child Support Services is required to obtain the policy name(s), policy number(s) and names(s) of person(s) covered. Oklahoma Child Support Services may also send an insurance survey to employers and insurers to obtain this additional information.
The Health Insurance Portability and Accountability Act (HIPAA) restrictions have no impact on the employer's obligation to enroll minor child(ren) of the employee and to report the information requested on the National Medical Support Notice and the insurance survey. This information is not protected health information as defined in 45 C.F.R. §164.501(Link opens in new window). Even if this information were to be construed as protected health information, a covered entity may disclose protected health information to the extent that disclosure is required by law or to an agency performing a government regulatory program. (45 C.F.R. §164.512(a) & (d)(1)(iii)) (Link opens in new window).