Medical Letters And Gathering Information About Coverage

Legal Authorities:

• 45 CFR 302.33, 302.56, 303.7, 303.30, and 303.31
• 36 O.S. § 6058A
• OAC 340:25-5-171 ITS

The letters CSS uses for enforcement of medical support are:

• Insurance Questionnaire – this letter is sent to a parent or custodian on the case to determine whether health care coverage is being provided or is available for the children from any source. This includes employer sponsored coverage, private policies, and alternative coverage such as Indian Health Services (IHS) and TRICARE.
  • AP version (M01)
  • CP version (M04)
• Medical Insurance Survey Letter – this letter is sent to employers to gather information about what type of health care coverage is available for the employee. The employer provides information about coverage available, cost of the coverage and the individuals who are currently enrolled in that coverage. There are two versions. The first is sent to employers of noncustodial parents and the second is sent to employers of custodial parties. This letter is commonly called the “Employer Medical Letter” and employers may refer to this letter as the “Employee Medical Insurance Survey.” If the necessary information is not provided on the form, OKESC will contact the employer when this document is accompanied by the National Medical Support Notice (NMSN – MED5/MED5C). This indicates the employer was ordered to enroll the children and no information has been provided to determine if enrollment has occurred.
  • NCP employer version (M05)
  • CP employer version (M05C)
• National Medical Support Notice (NMSN) – this is a federally mandated notice which has the effect of a court order for medical support. It directs the employer to enroll the children on a child support case in the health care coverage specified by the court order. If the employer refuses to cooperate, OKESC will notify the district office of the employer’s non-compliance. OSIS has multiple versions to fit the needs of the case.
  • NCP employer version (MED5)
  • CP employer version (MED5C)
• Employer Compliance Letter – this letter is sent to employers who fail to comply with the NMSN (MED5/MED5C). . It informs the employer that they could be subject to financial sanctions for failure to enroll the children as directed in the NMSN (MED5/MED5C). . If the employer still fails to comply, a Motion for Sanctions may be filed in district court.
  • NCP employer version (MED6)
  • CP employer version (MED6C)
• Termination of Medical Support – this notice is sent to employers to direct them to stop enforcing the medical support.
  • NCP employer version (MED8) for when the child ages out and notification is being given to the employer to inquire with the parents of whether the enrollment should discontinue for the child.
  • CP employer version (MED8C) for when the child ages out and notification is being given to the employer to inquire with the parents of whether the enrollment should discontinue for the child.
  • NCP employer version (MED7) for when the medical support must be terminated. This version is used when there is no question of whether the parents would elect to continue health care coverage (i.e., the court order has changed and the parent is no longer obligated to provide coverage).
  • CP employer version (MED7C) for when the medical support must be terminated. This version is used when there is no question of whether the parents would elect to continue health care coverage (i.e., the court order has changed and the parent is no longer obligated to provide coverage).

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