5101:12-47-01.1 Medical support provisions for health insurance and uncovered expenses.

(A) In any action or proceeding in which a child support enforcement agency (CSEA) issues or modifies a child support order, each party to the child support order is required to provide a list of any available private group health insurance policies, contracts, or plans to the CSEA.

(B) Based on information provided by the parties in accordance with paragraph (A) of this rule, when the CSEA issues or modifies a child support order, the CSEA shall include one of the following:

(1) A requirement that both the obligor and the obligee obtain private health insurance coverage for the child, if coverage that is reasonable in cost is available to both the obligor and the obligee and dual coverage will provide for coordination of medical benefits without unnecessary duplication of coverage.

(2) A requirement that the obligee obtain private health insurance coverage for the child, if coverage that is reasonable in cost is available through any group policy, contract, or plan available to the obligee and is available at a more reasonable cost than coverage is available to the obligor.

(3) A requirement that the obligor obtain private health insurance coverage for the child, if coverage that is reasonable in cost is available through any group policy, contract, or plan available to the obligor and is available at a more reasonable cost than coverage is available to the obligee.

(4) If private health insurance coverage for the child that is reasonable in cost is not available to the obligor or the obligee at the time that the child support order is issued, a requirement that the obligor and the obligee immediately inform the CSEA administering the child support order when private health insurance coverage for the child becomes available to either the obligor or the obligee.

(C) When a CSEA determines the medical support provision described in paragraph (B) of this rule, the CSEA shall consider any private health insurance in which the obligor, obligee, and/or child are enrolled at the time that the CSEA issues or modifies the child support order.

(D) In accordance with sections 3119.30 and 3119.32 of the Revised Code, in any action or proceeding in which the CSEA is issuing or modifying a child support order, the CSEA shall order or recommend the medical support provision for the shared responsibility of uncovered healthcare expenses.

(E) .

Variations from private health insurance standards for child support orders issued or modified in accordance with section 3119.30 of the Revised Code as adopted under Amended Substitute House Bill 119 of the 127th General Assembly.

(1) When the cost of private health insurance coverage for the child to either parent exceeds five per cent of that parent's annual gross income, the CSEA shall not order that parent to provide the private health insurance coverage for the child that exceeds the reasonable cost standard unless:

(a) Both parents agree that the parent be ordered to provide the private health insurance that exceeds the reasonable cost standard; or

(b) One of the parents requests to be ordered to provide the private health insurance that exceeds the reasonable cost standard.

When the CSEA issues the variation to the reasonable cost standard, the CSEA shall document the variation on the child support order.

(2) A CSEA may extend the thirty-mile accessibility standard for private health insurance when residents in part or all of the immediate geographic area customarily travel farther distances than thirty miles for primary care services. "Immediate geographic area" means the county in which the child resides. When the child's residence is within ten miles of the county line, "immediate geographic area" includes the county in which the child resides and any bordering county.

When the CSEA extends the thirty-mile accessibility standard, the CSEA shall document the variation on the child support order.

(3) A CSEA may expand the accessibility standard to include the requirement that the primary care services must be available by public transportation when the custodial parent or caretaker is dependent upon public transportation.

When the CSEA expands the accessibility standard to include the stipulation described in paragraph (E)(3) of this rule, the CSEA shall document the variation on the child support order.

Effective: 1/1/2015
Five Year Review (FYR) Dates: 08/26/2014 and 01/01/2020
Promulgated Under: 119.03
Statutory Authority: 3119.51
Rule Amplifies: 3119.30, 3119.31, 3119.32
Prior Effective Dates: 1/1/98, 10/2/03, 1/1/07, 3/1/09