Court-Ordered Health Coverage for Dependents

Overview

In Missouri, as well as other states, this procedure is handled through a notice (order) sent to the employer and plan administrator. In the City, these notices are sent first to the Treasurer’s Office and from there forwarded on to the City Employee Benefits Section for processing.

The Treasurer’s Office handles garnishments and sometimes the CSO notices accompany a garnishment; in those instances, the Treasurer’s Office has to do a financial test on the garnishments. Our Section is not involved in any aspects of any garnishments; we typically do not see that information come through unless there has been a mailing address issue. However, this is the reason why the CSO’s go to the Treasurer’s Office first.

These notices are referred to as Qualified Medical Child Support Order (QMCSO) or Court Support Order (CSO), we use the latter term, CSO.

This information is also available in PDF format.

Processing Deadlines

The employer has 20 business days to transfer the order to the plan administrator;

The plan administrator (City Employee Benefits) has 40 business days to respond to the notice. The plan administrator notices call for a confirmation of coverage and/or employee’s eligibility or non-eligibility or record no longer active in the system of record.

Plan Administrator Procedure

The Administrator receiving the order will take the following steps to process the court-ordered health coverage. Health coverage for the City, means Medical (Vision and Pharmacy plans embedded), and Dental insurance.

• Review the order
• Review the employee profile, if the employee is an active, bi-weekly (full-time) employee they are eligible for benefits. Is the person already enrolled in benefits? If they are, the child that the CSO addresses will be added to their current coverage with no change in plan option. If not enrolled, the eligible worker will be force enrolled under the Medical and Dental plans at the lowest PPO rate plan.
• The CSO administrator fills out the pertinent portions of the CSO notice after reviewing the enrollment aspects involved. The notice will then be returned to the respective Family Support Agency enforcing the coverage CSO.
• The completed CSO is emailed back or faxed to the requesting agency.
• The CSO is preserved in the employee’s benefit file under the enrollment folder.
• Next the CSO administrator will create an enrollment notification for the employee; this notice can be mailed via USPS; no copy of the CSO is included with this notice. The employee can reach out to our team for questions.
• If the CSO is for a non-Bi-Weekly, non-full-time worker, the notice response will detail this classification information and the coverage for the dependent will not be enforced.

Court Support Order Terminations

Just like enrollment requests are received, we also received order to end the coverage for dependent members, particularly when reaching the age of majority, age 18. In these instances, the CSO administrator reaches out to the employee to obtain consent on the removal; in some instances, employees want to keep their dependent covered until they age out from the plans, when reaching age 26.

The documentation requirements for a CSO termination is the same as an enrollment.

A CSO termination does not call for a notice to be filled out and returned to the requesting agency.

System Contingencies

• The CSO information received is documented in the City system of record. The data documented includes, order number; start or order, state of order and coverages being selected for the particular dependent. The system has a feature that once checked, will not allow for the CSO coverage to be removed.
• The medical and dental carriers are made aware of the CSO system flags for our members via the file feeds that transmit the membership data to ingest in their system.
• No CSO coverage should be removed, once in place, unless a termination notice is received by the employer.
• An employee request to remove their dependents covered under a CSO cannot be granted without an official termination notice.

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