Current through Register Vol. 49, No. 6, March 15, 2024
PURPOSE: This rule sets forth the Family Support
Division's procedures for establishing medical support obligations or modifying
existing orders to include medical support obligations in accordance with
sections
454.600 and
454.603,
RSMo Supp. 2019.
(1) For
purposes of this rule, the following terms will be defined as:
(A) "Gross Income" means the amount of money
earned prior to tax deductions and other mandatory or voluntary
deductions.
(B) "Parent Seeking
Support" means the person or state agency that will be entitled to receive
support after the entry of a support order.
(C) "Parent Not Seeking Support" means the
person who will be obligated to pay support after the entry of a support
order.
(D) "Private Health Benefit
Plan" means any benefit plan or combination of plans, other than public
assistance programs, providing medical or dental care or benefits through
insurance or otherwise, including, but not limited to, health service
corporations, as defined in section
354.010; prepaid
dental plans, as defined in section
354.700; health
maintenance organization plans, as defined in section
354.400; and
self-insurance plans, to the extent allowed by federal law.
(E) "Public Health Benefit Plan" means any
benefit plan or combination of plans, providing medical or dental care that is
funded under Title XIX or Title XXI of the Social Security Act.
(2) A health benefit plan through
an employer or union will be considered reasonable if the cost of dependent
coverage does not increase the current premiums of the parent who is to provide
such coverage by more than five percent (5%) of that parent's gross income. In
applying the five percent (5%) standard for the cost of health benefit plan
coverage, the cost will be the difference between self-only coverage and family
coverage, or the cost of adding the dependent(s) to existing coverage,
whichever is applicable given the individual's available plan options. If the
child(ren) is already covered by private health benefit plan coverage, the five
percent (5%) standard does not apply.
(3) A private health benefit plan is
accessible if the plan does not limit coverage to a specific geographical area;
or the plan limits coverage to a geographical area and the child(ren) reside(s)
within that geographical area.
(4)
The parent seeking support and the parent not seeking support will cooperate
with the division by providing necessary information to determine if health
benefit plan coverage through an employer or union is reasonable and
accessible. The parent seeking support and the parent not seeking support must
provide information within thirty (30) days of the date of the request from the
division. If only one (1) parent provides information, then the division will
use the information provided by that parent or information from other
sources.
(5) When establishing or
modifying a medical support obligation, the division will-
(A) Determine if the parent not seeking
support has the child(ren) covered by a private health benefit plan, and if so,
the division will order that parent to provide health benefit plan
coverage;
(B) If the parent not
seeking support does not have the child(ren) covered by a private health
benefit plan, the division will determine if the parent seeking support has the
child(ren) covered under a private health benefit plan. If the parent seeking
support does have the child(ren) covered and wants to maintain such coverage,
the division will order that parent to provide health benefit plan
coverage;
(C) If neither parent
maintains private health benefit plan coverage for the child(ren), the division
will determine if the parent not seeking support has private health benefit
plan coverage available at a reasonable cost. If the parent not seeking support
has private health benefit plan coverage available at a reasonable cost that is
accessible to the child(ren), the division will order that parent to provide
health benefit plan coverage;
(D)
If the parent not seeking support does not have private health benefit plan
coverage available at reasonable cost, the division will determine if the
parent seeking support has private health benefit plan coverage at a reasonable
cost. If the parent seeking support has private health benefit plan coverage
available at a reasonable cost that is accessible to the child(ren), the
division will order that parent to provide health benefit plan
coverage;
(E) If neither parent has
private health benefit plan coverage available at a reasonable cost that is
accessible to the child(ren) and the parent seeking support has the child(ren)
on public health benefit plan coverage, the division will order the parent not
seeking support to pay a percentage of uncovered costs of the child(ren)'s
necessary medical care. The percentage will be determined by using that
parent's percentage as set forth in line 4 of the Form 14 calculated by the
division or if the division does not calculate a Form 14 then the division will
order fifty percent (50%). If the parent not seeking support does not pay the
percentage of the reasonable costs of the child(ren)'s necessary medical care
as ordered, and a court has entered a sum-certain judgment regarding the amount
the parent owes for the child(ren)'s necessary medical care, the division will
collect the judgment amount; and
(F) If neither parent has private health
benefit plan coverage available at a reasonable cost that is accessible to the
child(ren) and the child(ren) are not enrolled in public health benefit plan,
the division will order the parent not seeking support to pay a percentage of
reasonable costs of the child(ren)'s necessary medical care. The percentage
will be determined by using that parent's percentage as set forth in line 4 of
the Form 14 calculated by the division or if the division does not calculate a
Form 14 then the division will order fifty percent (50%). If the parent not
seeking support does not pay the percentage of the reasonable costs of the
child(ren)'s necessary medical care as ordered, and a court has entered a
sum-certain judgment regarding the amount the parent owes for the child(ren)'s
necessary medical care, the division will collect the judgment
amount.
