A Qualified Medical Child Support Order (a “QMCSO”) is an Order entered by a Court pursuant to state domestic relations law (dissolution, legal separation, paternity, parentage) directing that a child who is a dependent of a participant in a group health plan (most, but not all, employer sponsored health plans are covered by this law) that is subject to the federal law known as ERISA to receive benefits under the health plan for as long as he or she is eligible for such coverage.
This means that the state court can enter an order directing that the eligible dependent be enrolled in the plan regardless of whether it is open enrollment. If the parent must be enrolled so the child may be enrolled, the Order may require both to be enrolled, at the parent’s cost. The Plan Administrator may withhold the required premiums from the parent’s paycheck, so long as the total amount being withheld does not exceed the maximum allowed by law.
A QMCSO cannot be used to create a right to coverage: If the Plan is not covered by ERISA or does not provide dependent coverage, a QMCSO will not create a right to dependent coverage.