110-136.14. Health insurer or health care plan administrator responsibilities.
(a) Upon receipt of the National Medical Support Notice from the employer, and within 40 business days after the date of the Notice, a health care plan administrator shall determine if the Notice is a "qualified medical child support order" (QMCSO), as defined under the Employee Retirement Income Security Act (ERISA) or the Child Support Performance and Incentive Act (CSPIA). If the Notice is not a qualified medical support order, the plan administrator shall inform the employer within the time set forth in this subsection.
(b) Upon receipt of the Notice in a nonqualified ERISA plan, or upon a finding that the Notice constitutes a qualified medical child support order, the health insurer or plan administrator shall enroll the dependent child or children in a health benefit plan, determine the cost of the coverage, and inform the employer of the amount of the employee contribution to be withheld from the obligor's wages, if appropriate. If the child or children are already enrolled in a health benefit plan, the employer shall be so notified. The employer shall also be notified of any applicable enrollment waiting periods.
(c) If there is more than one health benefit plan in which the dependent child or children may be enrolled, the insurer or plan administrator shall so inform the custodian within the time specified in this subsection. If no plan has been selected within 20 days from the date the insurer or administrator informed the agency of the option, the insurer or administrator may enroll the child or children in the insurer's or administrator's default option.
(d) If the obligor is subject to a waiting period for enrollment, the insurer or administrator shall inform the agency, the employer, the obligor, and the custodial parent. Upon the completion of the waiting period, the enrollment shall be instituted.
(e) When a court finds that a health insurer or health care plan administrator has failed to comply with this section, the employer is liable as a payor pursuant to G.S. 110-136.10(e). Additionally, a health insurer or health care plan administrator who violates this section is liable in a civil action for reasonable damages. (2001-237, s. 11.)
Structure North Carolina General Statutes
North Carolina General Statutes
§ 110-129.1 - Additional powers and duties of the Department.
§ 110-130 - Action by the designated representatives of the county commissioners.
§ 110-130.1 - Non-Work First services.
§ 110-130.2 - Collection of spousal support.
§ 110-131.1 - Notice; due process requirements met.
§ 110-132 - Affidavit of parentage and agreement to motion to set aside affidavit of parentage.
§ 110-132.1 - Paternity determination by another state entitled to full faith and credit.
§ 110-132.2 - Expedited procedures to establish paternity in IV-D cases.
§ 110-133 - Agreements of support.
§ 110-134 - Filing of affidavits, agreements, and orders; fees.
§ 110-135 - Debt to State created.
§ 110-136 - Garnishment for enforcement of child-support obligation.
§ 110-136.1 - Assignment of wages for child support.
§ 110-136.2 - Use of unemployment compensation benefits for child support.
§ 110-136.3 - Income withholding procedures; applicability.
§ 110-136.4 - Implementation of withholding in IV-D cases.
§ 110-136.5 - Implementation of withholding in non-IV-D cases.
§ 110-136.6 - Amount to be withheld.
§ 110-136.7 - Multiple withholding.
§ 110-136.8 - Notice to payor; payor's responsibilities.
§ 110-136.9 - Payment of withheld funds.
§ 110-136.10 - Termination of withholding.
§ 110-136.11 - National Medical Support Notice required.
§ 110-136.12 - IV-D agency responsibilities.
§ 110-136.13 - Employer responsibilities.
§ 110-136.14 - Health insurer or health care plan administrator responsibilities.
§ 110-138 - Duty of county to obtain support.
§ 110-138.1 - Duty of judicial officials to assist in obtaining support.
§ 110-139 - Location of absent parents.
§ 110-139.1 - Access to federal parent locator service; parental kidnapping and child custody cases.
§ 110-139.2 - Data match system; agreements with financial institutions.
§ 110-139.3 - High-volume, automated administrative enforcement in interstate cases (AEI).
§ 110-140 - Conformity with federal requirements; restriction on options without federal funding.