The National Medical Support Notice (NMSN) – Notice to Terminate Withholding for Health Care Coverage letter (MED7/MED7C). Instructs the employer to terminate the health care coverage on the child(ren). This is a federally mandated notice which has the effect of a court order regarding medical support.
While the party that is ordered to carry the health care coverage on the child(ren) is not legally required to keep the insurance in place after the emancipation of the child(ren) some parents do continue to cover the child(ren). Under the Affordable Care Act (ACA) a child(ren) may be kept on the parent’s employer sponsored health plan until they turn 26.
If we send a MED7/MED7C on a child that has emancipated the employer will terminate the insurance coverage. Once the coverage is terminated the only way that the child may be covered again is when that employer has open enrollment. The employee could then add the child(ren) back onto their policy. There is no document that CSS can send that will force the employer to place an emancipated child back on the insurance policy. Because of this we must use caution when sending the MED7/MED7C.
Here is an example of when sending the MED7/MED7C could cause harm to a child:
The NCP was ordered to carry the insurance on his child. He enrolls the child in his insurance policy with his employer. A CSS worker is reviewing the case and notices that the child has emancipated and sent the MED7 as the NCP is no longer required to carry the insurance. A couple of weeks later the NCP contacts CSS frantic that the coverage has been cancelled and wants us to do something to put the child back on his insurance. The worker finds out from the NCP that the child has cancer and is currently undergoing life saving treatment. There is no other coverage on the child, and they do not qualify for SoonerCare. Without the insurance coverage the child will not be able to get the treatments as they are too expensive for the NCP and CP to pay out of pocket for. The NCP can not add the child back onto his insurance policy until his employers open enrollment period which is six months away. The CSS worker must now explain to the NCP that we cannot do anything to help them. We cannot send a MED5/MED5C to enroll the child as they are no longer legally responsible to carry the insurance.
We don’t want to remove any child from an insurance policy unless they have emancipated and we have been asked to by the party ordered to carry the insurance. Another option in the case would be to send the MED8 which tells the employer that the employee is no longer legally required to carry the insurance and to check with their employee to see if they wish to remove the child or continue the coverage.
The only other time that it would be appropriate to send the MED7/MED7C on a case is if the employer enrolled the child(ren) in error and needs a document to remove them. An example of this would be if the employer enrolled the child(ren) and the cost was more than the reasonable cost limits.