Determination of Your Medical Child Support Order

What Happens If the Order Is Approved

• The Qualified Order Center will send a notice to all people named in the order and their designated representatives informing them that the order is approved.
• The child(ren) will be eligible to receive the health care coverage described in the QMCSO for the period to which the order applies.
• Coverage will follow the employer-specific plan rules concerning a start date. Unless specified in the QMCSO, coverage will end when the child is no longer eligible based on provisions of the plan.
• The employee's existing coverage may be changed due to the QMCSO. This may occur, for example, if the QMCSO specifies enrollment in a particular plan and the employee was enrolled in another plan.
• A Confirmation of Benefits statement will be sent to the employee if there is any change in his or her coverage.
• If the employee chose no coverage, the employee will be enrolled in coverage, if necessary, to let the child(ren) acquire coverage.

What Happens If the Order Is Denied

• The Qualified Order Center will notify all people named in the QMCSO and their designated representatives that the order is denied.
• The notice will indicate the reasons the order was denied.
• The plan won't cover medical expenses incurred by an eligible child(ren) until the health plan receives an order that is qualified and the child(ren) is enrolled.
• You may consider using the employer's model language in the revision.
• A revised court-certified order may be resubmitted for review to:

Qualified Order Center
PO Box 299082
Lewisville, TX 75029-9082

• A determination of the revised QMCSO will be made 15 business days after it's received.