The following information is needed in court to establish a medical support order:
- Income information
- Insurance is available at a reasonable cost and accessible to the child.
- Reasonable cost: The pro rata share of insurance does not exceed 5% of the gross income
- Accessible: No more than 60 miles one way from the residence of the child to the provider’s location
- A statement from the parent of the cost of insurance coverage with and without any adults included and the total number of children that are or will be covered.
- Whether insurance coverage is already being provided. Additionally, whether that coverage is an alternative coverage.
Determine the out-of-pocket cost for health insurance by subtracting any amount paid by the employer through a benefit allowance from the premium amount paid by the insured.
To calculate the actual premium cost of health insurance:
- Deduct the cost of coverage for the parent from the total insurance premium
- Deduct the cost of coverage for any other adults in the household, when that cost information is available from the total insurance premium;
- Divide the remainder by the number of dependent children covered; and
- Multiply the amount per child by the number of children in the child support case under consideration.
Total Insurance Premium – Cost of Coverage for Adults on Policy = Balance
Balance ÷ Number of Children Covered on Policy = Cost per child
Cost per child × Number of Children on Case = Cost of Insurance
If the cost of the insurance premium for other adults in the household is included with the cost for the child(ren) and information is not available to determine a separate amount for the other adults, use this premium cost to determine the amount per child.