2013 Maryland Code
FAMILY LAW
§ 12-102 - Award by court -- Inclusion of child on health insurance policy

§12-102.

(a) (1) In this section the following words have the meanings indicated.

(2) “Accessible” means health insurance coverage that insures primary care services located within the lesser of 30 miles or 30 minutes from the child’s primary residence.

(3) “Actual income” has the meaning stated in § 12-201(b) of this title.

(4) “Adjusted actual income” has the meaning stated in § 12-201 of this title.

(5) “Basic child support obligation” has the meaning stated in § 12-201 of this title.

(6) “Cash medical support” means an amount paid:

(i) toward the cost of health insurance provided by:

1. a public entity; or

2. one or both parents through employment or otherwise; or

(ii) for other medical costs not covered by insurance, including extraordinary medical expenses.

(7) “Extraordinary medical expenses” has the meaning stated in § 12-201 of this title.

(8) “Health insurance coverage” means any type of health care coverage under which medical care services can be provided to the child through an insurer.

(9) “Insurer” means:

(i) an insurer, a nonprofit health service organization, or a health maintenance organization operating in this State under a certificate of authority issued by the Maryland Insurance Commissioner;

(ii) an entity that provides a group health plan, as defined in § 607(1) of the Employee Retirement Income Security Act of 1974; or

(iii) an entity offering a service benefit plan as defined by federal law.

(10) “Medical support notice” means a notice that is:

(i) in a format prescribed by federal law; and

(ii) issued by a child support agency to enforce the health insurance coverage provisions of a child support order.

(11) “Tribunal” has the meaning stated in § 10-301 of this article.

(b) Except as provided in subsection (c) of this section, the court may include in any support order a provision requiring either parent to include the child in the parent’s health insurance coverage if:

(1) the parent can obtain health insurance coverage through an employer or any form of group health insurance coverage; and

(2) the child can be included at a reasonable cost to the parent in that health insurance coverage.

(c) (1) This subsection applies only to a child support order under Title IV, Part D of the Social Security Act.

(2) (i) The court shall include in any support order that is established or modified a provision requiring one or both parents to include the child in the parent’s health insurance coverage if:

1. the parent can obtain health insurance coverage through an employer or any form of group health insurance coverage;

2. the child can be included at a reasonable cost to the parent in that health insurance coverage; and

3. the health insurance coverage is accessible to the child.

(ii) For purposes of subparagraph (i)2 of this paragraph, the cost of health insurance coverage is reasonable if the cost of adding the child to existing health insurance coverage, or the difference between self-only and family coverage, does not exceed 5% of the actual income of the parent ordered to pay for health insurance coverage.

(3) If health insurance coverage at a reasonable cost is not available at the time a support order is established or modified, the court:

(i) may include a provision requiring one or both parents to include the child in the parent’s health insurance coverage as described in paragraph (2) of this subsection if health insurance coverage at a reasonable cost becomes available in the future; and

(ii) shall include a provision requiring one or both parents to provide cash medical support in an amount not to exceed 5% of the actual income of the parent ordered to provide cash medical support.

(4) In addition to requiring one or both parents to provide health insurance coverage, the court may order one or both parents to provide cash medical support in an amount not to exceed 5% of the actual income of the parent ordered to provide cash medical support.

(5) Cash medical support ordered under this subsection shall be added to the basic child support obligation and divided by the parents in proportion to their adjusted actual incomes.

(6) The court may not order the obligee to pay cash medical support toward the cost of health insurance provided by a public entity for which the obligee does not pay a premium, including the Maryland Children’s Health Program under Title 15, Subtitle 3 of the Health - General Article.

(d) An order of a court requiring the provision of health insurance coverage for a child may be issued separate from or in conjunction with an earnings withholding order.

(e) (1) If a court orders a parent to provide health insurance coverage under this section, the parent under the order or the support enforcement agency shall send a copy of the order or medical support notice to the parent’s employer by first-class mail, separate from or in conjunction with an earnings withholding order, as provided in § 10-123 of this article.

(2) Within 20 business days after the receipt of the order or medical support notice, the employer shall:

(i) send the appropriate part of the medical support notice to the employer’s insurer;

(ii) if the employer determines that, based on reasons related to the employee’s employment status, the employee’s child is ineligible for health insurance coverage, complete the appropriate part of the medical support notice and return it to the issuing child support agency;

(iii) permit the parent, a child support enforcement agency, or the Department of Health and Mental Hygiene to enroll the child in any health insurance coverage available to the parent without regard to any enrollment season restrictions;

(iv) provide a statement to the support enforcement agency and to both parents that the child:

1. has been enrolled in health insurance coverage;

2. will be enrolled in health insurance coverage and that the expected date of enrollment will be provided; or

3. cannot be enrolled in health insurance coverage; and

(v) provide information to both parents and to the support enforcement agency concerning the available health insurance coverage, including:

1. the employee’s Social Security number;

2. the name, address, and telephone number of the insurer;

3. the policy number;

4. the group number;

5. the effective date of coverage; and

6. any schedule of benefits.

(f) On receipt of the order or medical support notice, the employer:

(1) if the employee’s child is eligible for health insurance coverage, shall withhold from the employee’s next earnings the amount of the employee contribution required to enroll the employee’s child;

(2) if the employee’s child is not currently eligible for health insurance coverage but will become eligible, shall withhold from the employee’s earnings, at the earliest time the employee’s child becomes eligible, the amount of the employee contribution required to enroll the employee’s child; or

(3) if federal or State withholding limitations or prioritization prevent withholding from the employee’s wages the amount required for enrollment, shall complete and send, to the issuing child support agency, the appropriate part of the medical support notice indicating the employee’s income is insufficient for enrollment.

(g) (1) To the extent consistent with the federal Consumer Credit Protection Act, the employer shall deduct the premiums for health insurance coverage from the earnings of the employee on a regular and continuing basis and pay the premiums to the insurer.

(2) The employer shall send to the insurer the amount deducted from the employee’s earnings each pay period within 10 business days after the day on which the earnings are paid to the employee.

(h) An employer or the child’s parents may not disenroll or eliminate coverage for the child in any manner unless:

(1) the employer is provided satisfactory written evidence that:

(i) the court order is no longer in effect; or

(ii) the child has been or will be enrolled under other reasonable health insurance coverage, with the coverage to take effect no later than the effective date of disenrollment;

(2) the employer has eliminated family health coverage for all of its employees; or

(3) the employer no longer employs the parent under whose name the child has been enrolled for coverage except to the extent that if the parent elects to exercise the provisions of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) then coverage must be provided for the child consistent with the employer’s plan relating to postemployment medical coverage for dependents.

(i) (1) If the health insurance coverage for the child terminates, the employer shall notify the other parent and, if a support enforcement agency is involved in the case, the support enforcement agency within 15 days of termination of the insurance.

(2) If, after a lapse in health insurance coverage, health insurance coverage becomes available to the employee for the child, the employer shall:

(i) enroll the child in health insurance coverage without regard to any enrollment season restrictions; and

(ii) within 15 days after health insurance coverage becomes available, provide notice to the support enforcement agency and the other parent of the enrollment.

(j) Subject to the provisions of this section, the parent or the support enforcement agency may bring a civil action against an employer who willfully violates the provisions of this section.

(k) This section does not limit the authority of a court to enter, modify, or enforce an order requiring payment of uninsured health expenses, health care costs, or health insurance premiums.

(l) An employer may not use the existence of an order or a medical support notice requiring health insurance coverage as a basis for:

(1) reprisal against an employee;

(2) dismissal of an employee from employment; or

(3) refusal to hire a person or to promote an employee.

(m) An order entered under this section is binding on a present and future employer of the parent on whom a copy of this order is served.

§ 12-102 - 1. Award by court -- Medical support notice

(a) Issuance. -- A medical support notice:

(1) may be issued by a child support agency in any child support case in which a circuit court of this State or tribunal of another jurisdiction has ordered a parent to include the child in the parent's health insurance coverage; and

(2) shall be issued by a child support agency in all child support cases enforced by the Administration in which a noncustodial parent's employer is known and a circuit court of this State or tribunal of another jurisdiction has ordered the parent to include the child in the parent's health insurance coverage, unless the court order or administrative order provides for alternative health insurance coverage.

(b) Format and contents. -- A medical support notice shall:

(1) be in a format approved by the federal government;

(2) be a separate document that does not include any other orders or pleadings; and

(3) include the following information:

(i) a statement explaining the employer's obligations under this subtitle to withhold any employee contributions due in connection with health insurance coverage for the employee's child;

(ii) a statement explaining that, subject to further orders of the circuit court of this State or tribunal of another jurisdiction, the employer is required to withhold the appropriate amount on a regular and continuing basis beginning with the next pay period after receipt of the appropriate part of the medical support notice indicating the employee's child is eligible for enrollment;

(iii) an explanation of the application of the federal Consumer Credit Protection Act limits;

(iv) an explanation of the applicability of any prioritization required when available funds are insufficient for full withholding for both child support and medical support;

(v) any other information that the employer needs to comply with the medical support notice;

(vi) a statement that failure to comply with the medical support notice without good cause may subject the employer or carrier to civil penalties;

(vii) a statement of the employee's right to contest the withholding based on a mistake of fact; and

(viii) the name and telephone number of the appropriate person to contact at the Administration about the medical support notice.

(c) Priority. -- Subject to federal law, a medical support notice has priority over any other lien or legal process, except for current support and support arrears withheld under an earnings withholding order or notice.

(d) Force and effect. -- A medical support notice that is completed appropriately and satisfies the conditions of § 609(a) of Title I of the Employee Retirement Income Security Act shall:

(1) be treated as a qualified medical child support order by a carrier;

(2) have the same force and effect as a qualified medical child support order; and

(3) be enforceable in the same manner as a qualified medical child support order.

(e) Enforcement of notice from another state. -- A medical support notice issued in another state shall be enforced in the same manner as a medical support notice issued in this State.

§ 12-102 - 2. Award by court -- Order by foreign court

An administrative order or a medical support notice for health insurance coverage issued in any other state or territory will be enforced to the same extent in a proceeding under this subtitle as an order or a medical support notice for health insurance coverage issued in this State.

§ 12-102 - 3. Administrative contests of withholdings

(a) Application and construction. --

(1) This section applies to administrative contests of withholdings from an employee's earnings made by an employer for the purpose of complying with this title.

(2) Nothing in this section may be construed to limit an employee's right to judicially contest an underlying court order requiring the employee to provide health insurance coverage for the employee's child.

(b) Basis for administrative contests. --

(1) An employee may only contest a withholding under this section based on a mistake of fact.

(2) The only issues that may be contested are:

(i) the identity of the employee;

(ii) whether there is an underlying court order requiring the employee to provide health insurance coverage for the employee's child;

(iii) that the amount of the withholding exceeds the limits of the federal Consumer Credit Protection Act; and

(iv) that the child for whom health insurance coverage is sought is emancipated.

(c) Written request. -- An employee may contest a withholding by sending a written request for an investigation to the Administration within 15 days after receiving notice of the withholding from the employer.

(d) Investigation and notification of results. -- If an employee requests an investigation, the Administration:

(1) shall conduct an investigation within 15 days after the request; and

(2) on completion of the investigation, shall notify the employee of the results of the investigation and the employee's right to appeal the decision of the Administration to the Office of Administrative Hearings.

(e) Appeal. --

(1) (i) An employee may appeal the Administration's decision to the Office of Administrative Hearings by filing a written request for a hearing with the Administration or the Office of Administrative Hearings.

(ii) The request for a hearing shall be made:

1. on a form provided by the Administration; and

2. within 15 days after receiving the written results of the Administration's investigation.

(2) The only issues that may be contested in an administrative hearing are:

(i) the identity of the employee;

(ii) whether there is an underlying court order requiring the employee to provide health insurance coverage for the employee's child;

(iii) that the amount of the withholding exceeds the limits of the federal Consumer Credit Protection Act; and

(iv) that the child for whom health insurance coverage is sought is emancipated.

(3) An appeal under this section shall be conducted in accordance with Title 10, Subtitle 2 of the State Government Article.

(f) Rights of child pending contest. -- Enrollment of the employee's child may not be stayed or terminated until the employer receives written notice that the contest is resolved in the employee's favor.