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Question: We received a medical support notice for an employee’s dependent. The employee is eligible, but has elected to waive coverage. Do we have to enroll him?

Answer: The plan administrator must first determine if the order is qualified and, if so, provide coverage to the child.

In order to be qualified, a medical child support order must contain all of the following information:

  • The name and last known mailing address of the participant and each alternate recipient. The order may substitute the name and mailing address of a state or local official for the mailing address of any alternate recipient.
  • A reasonable description of the type of health coverage to be provided to each alternate recipient (or the manner in which such coverage is to be determined).
  • The period to which the order applies.

If the employee is eligible to participate in the plan, the support notice requires the child to be covered. This is not at the employee’s election. Furthermore, if, as a condition for covering his dependents, the employee must be enrolled, the plan must enroll both employee and child. This is typical of most plan agreements.