AN ACT
RELATING TO CHILD SUPPORT; REQUIRING
HEALTH CARE COVERAGE IN CHILD SUPPORT ORDERS AND THE USE OF THE NATIONAL
MEDICAL SUPPORT NOTICE; DECLARING AN EMERGENCY.
BE IT ENACTED BY THE LEGISLATURE OF
THE STATE OF NEW MEXICO:
Section 1. Section 40-4C-1 NMSA 1978 (being Laws 1990,
Chapter 78, Section 1) is amended to read:
"40-4C-1. SHORT TITLE.--Chapter 40, Article 4C NMSA
1978 may be cited as the "Mandatory Medical Support Act"."
Section 2. Section 40-4C-2 NMSA 1978 (being Laws 1990,
Chapter 78, Section 2) is amended to read:
"40-4C-2. PURPOSE.--To assure that children have access
to quality medical care, it is the purpose of the Mandatory Medical Support Act
to require parents responsible for the support of minor children to provide or
purchase health insurance and dental insurance coverage for those children when
such coverage is available."
Section 3. Section 40-4C-3 NMSA 1978 (being Laws 1990,
Chapter 78, Section 3, as amended) is amended to read:
"40-4C-3. DEFINITIONS.--As used in the Mandatory
Medical Support Act:
A. "court" means any district court
ordering child support of an obligor;
B. "dental insurance coverage" means
those coverages generally associated with a dental plan of benefits, not
including medicaid coverage authorized by Title 19 of the Social Security Act
and administered by the department;
C. "department" means the human
services department;
D. "employer" means an individual,
organization, agency, business or corporation hiring an obligor for pay;
E. "health insurance coverage" means
those coverages generally associated with a medical plan of benefits, not
including medicaid coverage authorized by Title 19 of the Social Security Act
and administered by the department;
F. "insurer" means an
employment-related or other group health care insurance plan, a health
maintenance organization, a nonprofit health care plan or other type of health
care insurance plan under which medical or dental services are provided,
regardless of service delivery mechanism;
G. "minor child" means a child younger
than eighteen years of age who has not been emancipated;
H. "national medical support notice"
means a court-ordered notice to an employer that an employee's child must be
covered by the employment-related group health care insurance plan;
I. "obligee" means a person to whom a
duty of support is owed or a person, including the department, who has
commenced a proceeding for enforcement of an alleged duty of support or for
registration of a support order, regardless of whether the person to whom a
duty of support is owed is a recipient of public assistance; and
J. "obligor" means a person owing a
duty of support or against whom a proceeding for the enforcement of a duty of
support or for registration of a support order is commenced."
Section 4. Section 40-4C-4 NMSA 1978 (being Laws 1990,
Chapter 78, Section 4) is amended to read:
"40-4C-4. MEDICAL SUPPORT--ORDER.--
A. The court shall order an obligor to name the
minor child on behalf of whom support is owed as an eligible dependent of
health insurance coverage or dental insurance coverage if:
(1) health insurance coverage or dental insurance
coverage that meets or exceeds the minimum standards required under the
Mandatory Medical Support Act is not available at a more reasonable cost to the
obligee than to the obligor for coverage of the minor child; and
(2) such health insurance coverage or dental
insurance coverage is available to the obligor through an employment-related or
other group health care insurance plan.
B. The court may consider the impact of the cost
of health insurance coverage or dental insurance coverage on the payment of the
base child support amounts in determining whether such insurance coverage shall
be ordered.
C. The court may order the obligor to obtain
health insurance coverage or dental insurance coverage for any minor child to
whom support is owed, if:
(1) the court finds that health insurance
coverage or dental insurance coverage for the minor child is not available to
the obligor through an employment-related or other group health care insurance
plan; and
(2) the obligee does not have such health
insurance coverage or dental insurance coverage available at a more reasonable
cost than the obligor for coverage of the minor child.
D. The court shall require the obligor to be
liable for all or a portion of the medical or dental expenses of the minor
child that are not covered by the required health insurance coverage or dental
insurance coverage, if:
(1) the court finds that the health insurance
coverage or dental insurance coverage required to be obtained by the obligor or
available to the obligee does not pay all the reasonable and necessary medical
or dental expenses of the minor child; and
(2) the court finds that the obligor has the
financial resources to contribute to the payment of these medical or dental
expenses.
E. The court shall require the obligor to
provide health insurance coverage or dental insurance coverage for the benefit
of the obligee if it is available at no additional cost to the obligor.
F. The court in any proceeding for the
establishment, enforcement or modification of a child support obligation may
modify an existing order of support or establish child support, as applicable,
for the minor child to incorporate the provisions for medical support ordered
pursuant to the Mandatory Medical Support Act."
Section 5. Section 40-4C-6 NMSA 1978 (being Laws 1990,
Chapter 78, Section 6, as amended) is amended to read:
"40-4C-6. OBLIGATIONS--EMPLOYERS, UNIONS AND
INSURERS--PLAN.--
A. Upon receipt of a national medical support
notice or the court order for health insurance coverage or dental insurance
coverage pursuant to Section 40-4C-5 NMSA 1978 or upon application of the
obligor pursuant to the court order, the employer or union shall enroll the
minor child as an eligible dependent in the health insurance plan or dental
insurance plan and withhold any required premium from the obligor's income or
wages. If more than one health insurance
plan or dental insurance plan is offered by the employer, union or insurer, the
minor child shall be enrolled in the plan in which the obligor is enrolled. If the obligor is not enrolled in a plan, the
child shall be enrolled in a plan that meets the minimum coverage criteria
required pursuant to the Mandatory Medical Support Act. If the obligor is not enrolled in a plan, the
premiums charged for the child or children of the obligor shall be those
charged for the enrollment of the obligor only.
B. In any instance in which the obligor is
required by a court order to provide health insurance coverage or dental
insurance coverage for the minor child and the obligor is eligible for health
insurance coverage or dental insurance coverage through an employment-related
or other group health care insurance plan, the employer, union or insurer shall
do the following:
(1) permit the obligor to enroll for health
insurance coverage or dental insurance coverage the minor child who is
otherwise eligible for coverage without regard to any enrollment season
restrictions;
(2) enroll the minor child for health insurance
coverage or dental insurance coverage if the obligor fails to enroll the minor
child upon application by the obligee or the department;
(3) not disenroll or eliminate coverage of any
minor child so enrolled unless:
(a) the employer is provided with satisfactory
written evidence that the court order is no longer in effect;
(b) the minor child is or will be enrolled in
comparable health coverage that meets the coverage criteria required pursuant
to the Mandatory Medical Support Act and that will take effect not later than
the effective date of the disenrollment;
(c) the obligor has terminated employment; or
(d) the employer has eliminated health insurance
coverage or dental insurance coverage for all of its employees; and
(4) withhold from the obligor's compensation the
obligor's share, if any, of premiums for health insurance coverage or dental
insurance coverage and to pay the share of premiums to the insurer, unless
otherwise provided in law or regulation.
C. In those instances where the obligor fails or
refuses to execute any document necessary to enroll the minor child in the
health insurance plan or dental insurance plan ordered by the court, the
required information and authorization may be provided by the department or the
custodial parent or guardian of the minor child.
D. Information and authorization provided by the
department or the custodial parent or guardian of the minor child shall be
valid for the purpose of meeting enrollment requirements of the health
insurance plan or dental insurance plan and shall not affect the obligation of
the employer or union and the insurer to enroll the minor child in
the health insurance plan or dental
insurance plan for which other eligibility, enrollment, underwriting terms and
other requirements are met. In instances
in which the minor child is insured through the obligor, the insurer shall
provide all information to the obligee that may be helpful or necessary for the
minor child to obtain benefits.
E. A minor child that an obligor is required to
cover as an eligible dependent pursuant to the Mandatory Medical Support Act
shall be considered for insurance coverage purposes as a dependent of the
obligor until the child is emancipated or until further order of the
court.
F. In instances in which the minor child is
insured through the obligor, the insurer is prohibited from denying health
insurance coverage or dental insurance coverage of the minor child on the
grounds that the minor child was born out of wedlock, that the minor child is
not claimed as a dependent on the obligor's federal income tax return or that
the minor child does not reside with the obligor or reside in the insurer's
service area.
G. In instances in which the minor child is
insured through the obligor, the insurer is prohibited from imposing
requirements on the department that are different from requirements applicable
to an agent or assignee of any other individual covered by the insurer.
H. In instances in which the minor child is
insured through the obligor, the insurer shall permit the obligee or health
care provider, with the approval of the obligee, to submit claims for covered
services without the approval of the obligor.
The insurer shall make payments on submitted claims directly to the
obligee or the health care provider.
I. When the obligor is terminated, the employer
shall notify the department of the termination."
Section 6. Section 40-4C-9 NMSA 1978 (being Laws 1990,
Chapter 78, Section 9) is amended to read:
"40-4C-9. AUTHORIZATION FOR CLAIMS.--The signature of
the custodial parent of the minor child insured pursuant to a court order or a
directive issued by the department is a valid authorization to the health insurer
or dental insurer for purposes of processing an insurance reimbursement
payment."
Section 7. Section 40-4C-10 NMSA 1978 (being Laws 1990,
Chapter 78, Section 10) is amended to read:
"40-4C-10. EMPLOYER, UNION OR INSURER NOTICE.--When an
order for health insurance coverage or dental insurance coverage pursuant to
the Mandatory Medical Support Act is in effect, upon termination of the
obligor's employment or upon termination of the insurance coverage, the employer,
union or insurer shall make a good faith effort to notify the obligee within
ten days of the termination date with notice of conversion privileges."
Section 8. Section 40-4C-11 NMSA 1978 (being Laws 1990,
Chapter 78, Section 11) is amended to read:
"40-4C-11. RELEASE OF INFORMATION.--When an order for
health insurance coverage or dental insurance coverage pursuant to the
Mandatory Medical Support Act is in effect, the obligor's employer, union or
insurer shall release to the obligee, upon request, information on such
coverage, including the name of the insurer."
Section 9. Section 40-4C-12 NMSA 1978 (being Laws 1990,
Chapter 78, Section 12, as amended) is amended to read:
"40-4C-12. OBLIGOR LIABILITY.--
A. An obligor who fails to maintain the health
insurance coverage or dental insurance coverage for the benefit of a minor
child as ordered pursuant to the Mandatory Medical Support Act shall be liable
to the obligee for any medical and dental expenses incurred from the date of
the court order.
B. An obligor who receives payment from a third
party for the costs of medical or dental services provided to a minor child and
who fails to use the payment to reimburse the department is liable to the
department to the extent of the department's payment for the services. The department is authorized to intercept the
obligor's tax refund or use other means of enforcement available to the
department to recoup amounts paid.
Claims for current or past due child support take priority over any
claims made pursuant to this subsection.
Proof of failure to maintain health insurance coverage or dental
insurance coverage as ordered constitutes a showing of increased need by the
obligee and provides a basis for modification of the obligor's child support
order.
C. An obligor is required to provide the
department with the following information concerning health insurance coverage
or dental insurance coverage:
(1) obligor's name and tax identification number;
(2) type of coverage (single or family);
(3) name, address and identifying number of
health insurance coverage or dental insurance coverage;
(4) name and tax identification number of other
individuals who are provided health insurance coverage or dental insurance
coverage by the obligor;
(5) effective period of coverage; and
(6) name, address and the tax identification
number of the employer."
Section 10. Section 40-4C-13 NMSA 1978 (being Laws 1990,
Chapter 78, Section 13, as amended) is amended to read:
"40-4C-13. DEPARTMENT--DUTIES.--The department shall
implement and enforce an order for health insurance coverage or dental
insurance coverage when the minor child receives public assistance or medicaid
or upon application of the obligee to the department and payment by the obligee
of any fees required by the department."
Section 11. EMERGENCY.--It is necessary for the public
peace, health and safety that this act take effect immediately.
HB 614
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