Medical support coverage services are provided for any CP in an NPA
case, unless the CP and child have satisfactory coverage available
other than Medicaid. All NPA CPs must be advised that medical support
services are provided, and the services must be explained to them.
NPA CPs cannot choose to receive only medical support services. CPs
must be provided the full range of child support services to be
eligible for services from the CSS program. This includes the
redirection and enforcement of an existing child support order. CSS
must advise NPA CPs who refuse to cooperate with the establishment and
enforcement of medical insurance that this can be grounds to terminate
services if neither party in the CSS case has adequate coverage for
the child. CSS must provide new applicants, as well as existing CPs,
with this information when establishing a new support order or during
the review and adjustment process.
DOCUMENTATION AND VERIFICATION OF HEALTH INSURANCE
Local CSS caseworkers must discuss the availability of dependent
health insurance coverage with both the custodial parent (CP) and the
noncustodial parent (NCP) and fully document the results of this
discussion on the Application Checklist. Employers and insurance
providers are required to provide medical, hospital, and dental
insurance information concerning a minor child's coverage upon written
request. When requesting information from an employer, caseworkers
should cite NCGS 50-13.11, which requires the release of this
information to the agency.
Following the entry or modification of any order to require the NCP to
obtain health insurance, caseworkers must verify that the coverage was
actually obtained. The necessary dependent health insurance
information must be obtained from either the NCP, employer, or health
insurance carrier and forwarded to the appropriate parties.
If the CP is providing health coverage, caseworkers must verify this
coverage and document the information in ACTS. Following the entry or
modification of any order to require the NCP to obtain health
insurance, caseworkers must verify that the coverage was actually
obtained. The necessary dependent health insurance information must
be obtained from either the NCP, employer, or health insurance carrier
and forwarded to the appropriate parties.
Caseworkers must send the National Medical Support Notice (DSS-4733)
to the employer within five (5) business days of the entry of an
initial order that includes a provision for employment-based medical
insurance coverage, within two (2) business days of an NCP being added
to the New Hire directory, or as soon as the caseworker becomes aware
that the NCP has changed employment.
If no response is received from the employer and/or plan administrator
Within forty (40) days, CSS should contact the employer and/or plan
administrator to resolve the problem. Civil legal action can be taken
against the employer or health plan administrator if dependent
coverage is available but the NCP's child is not enrolled.
If an NCP claims to be paying support in more than one county, CSS
must verify whether credit was given for the insurance cost. Credit