No. 32951 (Amendment): Rule R527-201. Medical Support Services

(Amendment)

DAR File No.: 32951
Filed: 09/09/2009 03:18:07 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this amendment is to delete the first subsection of Section R527-201-8. If a child support order or underlying worksheet gives a specific insurance credit for the children's portion of the insurance premium and later the insurance premium increases or decreases, at the recommendation of legal counsel, the Office of Recovery Services/Child Support Services (ORS/CSS) will only enforce the insurance as ordered. Also, Subsection R527-201-9(9) has been updated to add clarification per Subsection 62A-11-406(9).

Summary of the rule or change:

Delete the Subsection R527-201-8(1) and renumber the subsequent subsections in this section. Break out Subsection R527-201-9(9) to add more clarification per Subsection 62A-11-406(9).

State statutory or constitutional authorization for this rule:

• Section 62A-11-107
• Section 62A-1-111
• Section 62A-11-326
• Subsection 62A-11-103(2)

Anticipated cost or savings to:

the state budget:

There should be a small savings to the state budget because ORS/CSS will no longer adjust the insurance credit on a case when the party providing insurance obtains new insurance and the premium cost is less, making the new insurance credit less than the amount specified in the order. This process can be time consuming as it requires the office to gather information from the party providing insurance, make a mathematical determination as to the new insurance credit amount, adjust the income withholding accordingly, send notices to the employers and custodial parents, and make appropriate adjustment to the office computer system.

local governments:

Administrative rules of ORS/CSS do not apply to local governments, because the rules primarily affect the internal procedures of the office; therefore, there are no anticipated costs or savings for any local government due to this amendment.

small businesses:

There could be a small savings to small businesses because they will no longer receive and be required to process the amended income withholding orders that are sent as a result of the office determining a new lower insurance credit amount on these type of cases.

persons other than small businesses, businesses, or local governmental entities:

There should be no anticipated costs for persons other than business as the changes primarily affect the internal procedures of ORS/CSS and provide clarification to the child support staff.

Compliance costs for affected persons:

In order for the parents to receive a lower or higher insurance credit on a case where the order has a specific insurance credit amount, the parties must now incur the costs associated with modifying an order. But it is hard to determine how many of these parents will actually modify the order, because some of the parties will choose not to incur the costs and leave the ordered insurance credit amount as is.

Comments by the department head on the fiscal impact the rule may have on businesses:

The impact to businesses as a result of these changes to this rule should be minimal, because most of the cases with Utah orders already have language that allows ORS/CSS to adjust the insurance credit amount higher or lower as the insurance premium or number of individual covered on a policy changes.

Lisa-Michele Church, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Human Services
Recovery Services
515 E 100 S
SALT LAKE CITY, UT 84102-4211

Direct questions regarding this rule to:

• LeAnn Wilber at the above address, by phone at 801-536-8950, by FAX at 801-536-8833, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

11/02/2009

This rule may become effective on:

11/09/2009

Authorized by:

Mark Brasher, Director

RULE TEXT

R527. Human Services, Recovery Services.

R527-201. Medical Support Services.

R527-201-6. Securing a Medical Support Provision in the Support Order.

1. Notice to potentially obligated parents: The notice to potentially obligated parents shall include a provision that an administrative or judicial proceeding will occur to:

a. order either parent to purchase and maintain appropriate medical insurance for the children, and

b. order both parents to pay cash medical support.[]

This notification shall be provided when either of the following conditions is met:

a. the state initiates an action to establish a final support order or to adjust an existing child support order; or

b. the state joins a divorce or modification action initiated by either the custodial or the non-custodial parent.

2. If a judicial support order does not include a medical support provision, ORS/CSS shall commence judicial action to modify the order to include a medical support provision.

R527-201-8. Credit for Premium Payments and Effect of Changes to the Premium Amount Subsequent to the Order.

1. [If the order or underlying worksheet gives credit of a specific amount for the children's portion of the premium and the amount of the premium decreases, ORS/CSS may reduce the amount of the credit without seeking a modification of the order.

2. ]If the order or underlying worksheet does not mention a specific credit for insurance premiums, ORS/CSS shall give credit for the child(ren)'s portion of the insurance premium when the obligated parent provides the necessary verification coverage.

[3]2. ORS/CSS shall notify both parents in writing whenever the credit is changed.

R527-201-9. Enforcement of Obligation to Maintain Medical and Dental Insurance.

1. In Non-IV-A cases and in IV-A Medicaid cases, appropriate steps shall be taken to ensure compliance with orders which require the obligated parent to maintain insurance. Obligated parents shall demonstrate compliance by providing ORS/CSS with policy numbers and the insurance provider name for the dependent children for whom the medical support is ordered.

2. In Non-IV-A cases and in IV-A Medicaid cases, if an obligated parent has been ordered to maintain insurance and insurance is accessible and available at a reasonable cost, ORS/CSS shall use the NMSN to transfer notice of the insurance provision to the obligated parent's employer unless ORS/CSS is notified pursuant to Section 62A-11-326.1 that the children are already enrolled in an insurance plan in accordance with the order.

3. When appropriate, ORS/CSS shall send the NMSN to the obligated parent's employer within two business days after the name of the obligated parent has been entered into the registry of the State Directory of New Hires, matched with ORS/CSS records, and reported to ORS/CSS in accordance with Subsection 35A-7-105(2).

4. The employer shall transfer the NMSN to the appropriate group health plan for which the children are eligible within twenty business days of the date of the NMSN if all of the following criteria are met:

a. the obligated parent is still employed by the employer;

b. the employer maintains or contributes to plans providing dependent or family health coverage;

c. the obligated parent is eligible for the coverage available through the employer; and

d. state or federal withholding limitations, prioritization, or both, do not prevent withholding the amount required to obtain coverage.

5. If more than one coverage option is available under a group insurance plan and the obligated parent is not already enrolled, ORS/CSS in consultation with the custodial parent may select the least expensive option if the option complies with the child support order and benefits the children. The insurer shall enroll the children in the plan's default option or least expensive option in accordance with Subsection 62A-11-326.2(1)(b) unless another option is specified by ORS/CSS.

6. The employer shall determine if the necessary employee contributions for the insurance coverage are available. If the amounts necessary are available, the employer shall begin withholding when appropriate and remit directly to the plan.

7. In accordance with Subsections 62A-11-326.1(2) and (3), the obligated parent may contest withholding insurance premiums based on a mistake of fact. The employer shall continue withholding under the NMSN until notified by ORS/CSS to terminate withholding insurance premiums.

8. If a parent successfully contests the action to enroll the children in a group health plan based on a mistake of fact, ORS/CSS shall notify the employer to discontinue enrollment and withholding insurance premiums for the children.

9. In accordance with Subsection 62A-11-406(9), the employer shall :

a. [promptly ]notify ORS/CSS within five days after[when] the obligated parent['s] terminates employment[is terminated];

b. provide the office with the obligated parent's last-known address; and

c. the name and address of any new employer, if known.

10. ORS/CSS shall promptly notify the employer when a current order for medical support is no longer in effect for which ORS/CSS is responsible.

KEY: child support, health insurance, Medicaid

Date of Enactment or Last Substantive Amendment: [ June 2 ], 2009

Notice of Continuation: January 16, 2007

Authorizing, and Implemented or Interpreted Law: 62A-1-111; 62A-11-103(2); 62A-11-107; 62A-11-326; 62A-11-326.1; 62A-11-326.2; 62A-11-326.3; 62A-11-406(9); 63G-4-102 et seq.; 78B-12-102(6); 78B-12-212; 35A-7-105(2); 45 CFR 303.30; 45 CFR 303.31; 45 CFR 303.32

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