(1)
Whenever a parent has been ordered to provide medical support for
a dependent child, the department or the other parent may seek
enforcement of the medical support as provided under this
section.
(a) If the obligated parent provides proof that he or she
provides accessible coverage for the child through private
insurance, that parent has satisfied his or her obligation to
provide health insurance coverage.
(b) If the obligated parent does not provide proof of
coverage, either the department or the other parent may take
appropriate action as provided in this section to enforce the
obligation.
(2) The department may attempt to enforce a parent's
obligation to provide health insurance coverage for the dependent
child. If health insurance coverage is not available through the
parent's employment or union at a cost not to exceed twenty-five
percent of the parent's basic support obligation, or as otherwise
provided in the support order, the department may enforce any
monthly payment toward the premium ordered to be provided under
RCW 26.09.105 or 74.20A.300.
(3) A parent seeking to enforce another parent's monthly
payment toward the premium under RCW 26.09.105 may:
(a) Apply for support enforcement services from the division
of child support as provided by rule; or
(b) Take action on his or her own behalf by:
(i) Filing a motion in the underlying superior court action;
or
(ii) Initiating an action in superior court to determine the
amount owed by the obligated parent, if there is not already an
underlying superior court action.
(4)(a) The department may serve a notice of support owed
under RCW 26.23.110 on a parent to determine the amount of that
parent's monthly payment toward the premium.
(b) Whether or not the child receives temporary assistance
for needy families or medicaid, the department may enforce the
responsible parent's monthly payment toward the premium. When
the child receives state-financed medical coverage through the
department under chapter 74.09 RCW for which there is an
assignment, the department may disburse amounts collected to the
custodial parent to be used for the medical costs of the child or
the department may retain amounts collected and apply them toward
the cost of providing the child's state-financed medical
coverage. The department may disregard monthly payments toward
the premium which are passed through to the family in accordance
with federal law.
(5)(a) If the order to provide health insurance coverage
contains language notifying the parent ordered to provide
coverage that failure to provide such coverage or proof that such
coverage is unavailable may result in direct enforcement of the
order and orders payments through, or has been submitted to, the
Washington state support registry for enforcement, then the
department may, without further notice to the parent, send a
national medical support notice pursuant to 42 U.S.C. Sec.
666(a)(19), and sections 401 (e) and (f) of the federal child
support and performance incentive act of 1998 to the parent's
employer or union. The notice shall be served:
(i) By regular mail;
(ii) In the manner prescribed for the service of a summons
in a civil action;
(iii) By certified mail, return receipt requested; or
(iv) By electronic means if there is an agreement between
the secretary of the department and the person, firm,
corporation, association, political subdivision, department of
the state, or agency, subdivision, or instrumentality of the
United States to accept service by electronic means.
(b) The notice shall require the employer or union to enroll
the child in the health insurance plan as provided in subsection
(8) of this section.
(c) The returned part A of the national medical support
notice to the division of child support by the employer
constitutes proof of service of the notice in the case where the
notice was served by regular mail.
(6) Upon receipt of a national medical support notice from a
child support agency operating under Title IV-D of the federal
social security act:
(a) The parent's employer or union shall comply with the
provisions of the notice, including meeting response time frames
and withholding requirements required under part A of the notice;
(b) The parent's employer or union shall also be responsible
for complying with forwarding part B of the notice to the child's
plan administrator, if required by the notice;
(c) The plan administrator is responsible for complying with
the provisions of the notice.
(7) If the parent's order to provide health insurance
coverage does not order payments through, and has not been
submitted to, the Washington state support registry for
enforcement:
(a) The parent seeking enforcement may, without further
notice to the obligated parent, send a certified copy of the
order requiring health insurance coverage to the parent's
employer or union by certified mail, return receipt requested;
and
(b) The parent seeking enforcement shall attach a notarized
statement to the order declaring that the order is the latest
order addressing coverage entered by the court and require the
employer or union to enroll the child in the health insurance
plan as provided in subsection (8) of this section.
(8) Upon receipt of an order that provides for health
insurance coverage:
(a) The parent's employer or union shall answer the party
who sent the order within twenty days and confirm that the child:
(i) Has been enrolled in the health insurance plan;
(ii) Will be enrolled; or
(iii) Cannot be covered, stating the reasons why such
coverage cannot be provided;
(b) The employer or union shall withhold any required
premium from the parent's income or wages;
(c) If more than one plan is offered by the employer or
union, and each plan may be extended to cover the child, then the
child shall be enrolled in the parent's plan. If the parent's
plan does not provide coverage which is accessible to the child,
the child shall be enrolled in the least expensive plan otherwise
available to the parent;
(d) The employer or union shall provide information about
the name of the health insurance coverage provider or issuer and
the extent of coverage available to the parent and shall make
available any necessary claim forms or enrollment membership
cards.
(9) If the order for coverage contains no language notifying
either or both parents that failure to provide health insurance
coverage or proof that such coverage is unavailable may result in
direct enforcement of the order, the department or the parent
seeking enforcement may serve a written notice of intent to
enforce the order on the obligated parent by certified mail,
return receipt requested, or by personal service. If the parent
required to provide medical support fails to provide written
proof that such coverage has been obtained or applied for or
fails to provide proof that such coverage is unavailable within
twenty days of service of the notice, the department or the
parent seeking enforcement may proceed to enforce the order
directly as provided in subsection (5) of this section.
(10) If the parent ordered to provide health insurance
coverage elects to provide coverage that will not be accessible
to the child because of geographic or other limitations when
accessible coverage is otherwise available, the department or the
parent seeking enforcement may serve a written notice of intent
to purchase health insurance coverage on the obligated parent by
certified mail, return receipt requested. The notice shall also
specify the type and cost of coverage.
(11) If the department serves a notice under subsection (10)
of this section the parent required to provide medical support
shall, within twenty days of the date of service:
(a) File an application for an adjudicative proceeding; or
(b) Provide written proof to the department that the
obligated parent has either applied for, or obtained, coverage
accessible to the child.
(12) If the parent seeking enforcement serves a notice under
subsection (10) of this section, within twenty days of the date
of service the parent required to provide medical support shall
provide written proof to the parent seeking enforcement that he
or she has either applied for, or obtained, coverage accessible
to the child.
(13) If the parent required to provide medical support fails
to respond to a notice served under subsection (10) of this
section to the party who served the notice, the party who served
the notice may purchase the health insurance coverage specified
in the notice directly.
(a) If the obligated parent is the responsible parent, the
amount of the monthly premium shall be added to the support debt
and be collectible without further notice.
(b) If the obligated parent is the custodial parent, the
responsible parent may file an application for enforcement
services and ask the department to establish and enforce the
custodial parent's obligation.
(c) The amount of the monthly premium may be collected or
accrued until the parent required to provide medical support
provides proof of the required coverage.
(14) The signature of the parent seeking enforcement or of a
department employee shall be a valid authorization to the
coverage provider or issuer for purposes of processing a payment
to the child's health services provider. An order for health
insurance coverage shall operate as an assignment of all benefit
rights to the parent seeking enforcement or to the child's health
services provider, and in any claim against the coverage provider
or issuer, the parent seeking enforcement or his or her assignee
shall be subrogated to the rights of the parent obligated to
provide medical support for the child. Notwithstanding the
provisions of this section regarding assignment of benefits, this
section shall not require a health care service contractor
authorized under chapter 48.44 RCW or a health maintenance
organization authorized under chapter 48.46 RCW to deviate from
their contractual provisions and restrictions regarding
reimbursement for covered services. If the coverage is
terminated, the employer shall mail a notice of termination to
the department or the parent seeking enforcement at that parent's
last known address within thirty days of the termination date.
(15) This section shall not be construed to limit the right
of the parents or parties to the support order to bring an action
in superior court at any time to enforce, modify, or clarify the
original support order.
(16) Where a child does not reside in the issuer's service
area, an issuer shall cover no less than urgent and emergent
care. Where the issuer offers broader coverage, whether by
policy or reciprocal agreement, the issuer shall provide such
coverage to any child otherwise covered that does not reside in
the issuer's service area.
(17) If a parent required to provide medical support fails
to pay his or her portion, determined under RCW 26.19.080, of any
premium, deductible, copay, or uninsured medical expense incurred
on behalf of the child, pursuant to a child support order, the
department or the parent seeking reimbursement of medical
expenses may enforce collection of the obligated parent's portion
of the premium, deductible, copay, or uninsured medical expense
incurred on behalf of the child.
(a) If the department is enforcing the order and the
responsible parent is the obligated parent, the obligated
parent's portion of the premium, deductible, copay, or uninsured
medical expenses incurred on behalf of the child added to the
support debt and be collectible without further notice, following
the reduction of the expenses to a sum certain either in a court
order or by the department, pursuant to RCW 26.23.110.
(b) If the custodial parent is the obligated parent, the
responsible parent may file an application for enforcement
services and ask the department to establish and enforce the
custodial parent's obligation.
(18) As used in this section:
(a) "Accessible" means health insurance coverage which
provides primary care services to the child or children with
reasonable effort by the custodian.
(b) "Cash medical support" means a combination of: (i) A
parent's monthly payment toward the premium paid for coverage by
either the other parent or the state, which represents the
obligated parent's proportionate share of the premium paid, but
no more than twenty-five percent of the obligated parent's basic
support obligation; and (ii) a parent's proportionate share of
uninsured medical expenses.
(c) "Health insurance coverage" does not include medical
assistance
provided under chapter 74.09 RCW.
(d) "Uninsured medical expenses" includes premiums, copays,
deductibles, along with other health care costs not covered by
insurance.
(e) "Obligated parent" means a parent ordered to provide
health insurance coverage for the children.
(f) "Monthly payment toward the premium" means a parent's
contribution toward premiums paid by the other parent or the
state for insurance coverage for the child, which is based on the
obligated parent's proportionate share of the premium paid, but
no more than twenty-five percent of the obligated parent's basic
support obligation.
(19) The department has rule-making authority to enact rules
consistent with 42 U.S.C. Sec. 652(f) and 42 U.S.C. Sec.
666(a)(19) as amended by section 7307 of the deficit reduction
act of 2005. Additionally, the department has rule-making
authority to implement regulations required under 45 C.F.R. Parts
302, 303, 304, 305, and 308.
[2009 c 476 § 2; 2007 c 143 § 1; 2000 c 86 § 2; 1995 c 34 § 7; 1994 c 230 § 7; 1993 c 426 § 14; 1989 c 416 § 5.]
NOTES:
Effective date -- 2009 c 476: See note following RCW 26.09.105.
Severability -- 2007 c 143: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [2007 c 143 § 10.]