§ 110‑136.14. Health insurer or health careplan administrator responsibilities.
(a) Upon receipt of the National Medical Support Notice from theemployer, and within 40 business days after the date of the Notice, a healthcare plan administrator shall determine if the Notice is a "qualifiedmedical child support order" (QMCSO), as defined under the EmployeeRetirement Income Security Act (ERISA) or the Child Support Performance andIncentive Act (CSPIA). If the Notice is not a qualified medical support order,the plan administrator shall inform the employer within the time set forth inthis subsection.
(b) Upon receipt of the Notice in a nonqualified ERISA plan, orupon a finding that the Notice constitutes a qualified medical child supportorder, the health insurer or plan administrator shall enroll the dependentchild 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 bewithheld from the obligor's wages, if appropriate. If the child or children arealready enrolled in a health benefit plan, the employer shall be so notified.The employer shall also be notified of any applicable enrollment waitingperiods.
(c) If there is more than one health benefit plan in which thedependent child or children may be enrolled, the insurer or plan administratorshall so inform the custodian within the time specified in this subsection. Ifno plan has been selected within 20 days from the date the insurer oradministrator informed the agency of the option, the insurer or administratormay enroll the child or children in the insurer's or administrator's defaultoption.
(d) If the obligor is subject to a waiting period forenrollment, the insurer or administrator shall inform the agency, the employer,the obligor, and the custodial parent. Upon the completion of the waitingperiod, the enrollment shall be instituted.
(e) When a court finds that a health insurer or health care planadministrator has failed to comply with this section, the employer is liable asa payor pursuant to G.S. 110‑136.10(e). Additionally, a health insurer orhealth care plan administrator who violates this section is liable in a civilaction for reasonable damages. (2001‑237, s.11.)
§ 110‑136.14. Health insurer or health careplan administrator responsibilities.
(a) Upon receipt of the National Medical Support Notice from theemployer, and within 40 business days after the date of the Notice, a healthcare plan administrator shall determine if the Notice is a "qualifiedmedical child support order" (QMCSO), as defined under the EmployeeRetirement Income Security Act (ERISA) or the Child Support Performance andIncentive Act (CSPIA). If the Notice is not a qualified medical support order,the plan administrator shall inform the employer within the time set forth inthis subsection.
(b) Upon receipt of the Notice in a nonqualified ERISA plan, orupon a finding that the Notice constitutes a qualified medical child supportorder, the health insurer or plan administrator shall enroll the dependentchild 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 bewithheld from the obligor's wages, if appropriate. If the child or children arealready enrolled in a health benefit plan, the employer shall be so notified.The employer shall also be notified of any applicable enrollment waitingperiods.
(c) If there is more than one health benefit plan in which thedependent child or children may be enrolled, the insurer or plan administratorshall so inform the custodian within the time specified in this subsection. Ifno plan has been selected within 20 days from the date the insurer oradministrator informed the agency of the option, the insurer or administratormay enroll the child or children in the insurer's or administrator's defaultoption.
(d) If the obligor is subject to a waiting period forenrollment, the insurer or administrator shall inform the agency, the employer,the obligor, and the custodial parent. Upon the completion of the waitingperiod, the enrollment shall be instituted.
(e) When a court finds that a health insurer or health care planadministrator has failed to comply with this section, the employer is liable asa payor pursuant to G.S. 110‑136.10(e). Additionally, a health insurer orhealth care plan administrator who violates this section is liable in a civilaction for reasonable damages. (2001‑237, s.11.)
§ 110‑136.14. Health insurer or health careplan administrator responsibilities.
(a) Upon receipt of the National Medical Support Notice from theemployer, and within 40 business days after the date of the Notice, a healthcare plan administrator shall determine if the Notice is a "qualifiedmedical child support order" (QMCSO), as defined under the EmployeeRetirement Income Security Act (ERISA) or the Child Support Performance andIncentive Act (CSPIA). If the Notice is not a qualified medical support order,the plan administrator shall inform the employer within the time set forth inthis subsection.
(b) Upon receipt of the Notice in a nonqualified ERISA plan, orupon a finding that the Notice constitutes a qualified medical child supportorder, the health insurer or plan administrator shall enroll the dependentchild 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 bewithheld from the obligor's wages, if appropriate. If the child or children arealready enrolled in a health benefit plan, the employer shall be so notified.The employer shall also be notified of any applicable enrollment waitingperiods.
(c) If there is more than one health benefit plan in which thedependent child or children may be enrolled, the insurer or plan administratorshall so inform the custodian within the time specified in this subsection. Ifno plan has been selected within 20 days from the date the insurer oradministrator informed the agency of the option, the insurer or administratormay enroll the child or children in the insurer's or administrator's defaultoption.
(d) If the obligor is subject to a waiting period forenrollment, the insurer or administrator shall inform the agency, the employer,the obligor, and the custodial parent. Upon the completion of the waitingperiod, the enrollment shall be instituted.
(e) When a court finds that a health insurer or health care planadministrator has failed to comply with this section, the employer is liable asa payor pursuant to G.S. 110‑136.10(e). Additionally, a health insurer orhealth care plan administrator who violates this section is liable in a civilaction for reasonable damages. (2001‑237, s.11.)
