Child Support Enforcement - Sarpy County Nebraska

§ 4-215. Child(ren)‟s health insurance, nonreimbursed health care expenses, and cash
medical support in Title IV-D cases.
. . .
(C) Cash Medical Support and Health Care Costs for Title IV-D Cases Only.
(i) All child support orders in the Title IV-D program must address how the parties will
provide for the child(ren)’s health care needs through health care coverage and/or through
cash medical support. Cash medical support or the cost of private health insurance is
considered reasonable in cost if the cost to the party responsible for providing medical
support for the child(ren) does not exceed 3 percent of his or her gross income. In applying
the 3-percent standard, the cost is the cost of adding the child(ren) to existing health care
coverage or the difference between self-only and family health care coverage. Cash medical
support payment shall not be ordered if, at the time that the order is issued or modified, the
responsible party’s income is, or such expense would reduce the responsible party’s net
income, below the basic subsistence limitation provided in § 4-218. If a court orders a parent
to pay cash medical support, it shall be in lieu of, and not in addition to, requiring the parent
to also pay reimbursement for reasonable and necessary children's health care costs as set
forth in subsection (B), above.
(ii) The amount of cash medical support ordered in the case shall be prorated between the
parents. When worksheet 1 is used, it shall be added to the monthly support from line 7, then
prorated between the parents to arrive at each party’s share of monthly support on line 10 of
worksheet 1. The parent paying the cash medical support receives a credit against his or her
share of the monthly support.
See also federal rules and regulations for Qualified Medical Child Support Orders
(QMCSO) at 29 U.S.C. 1169(a). Every employer group health plan must honor a properly
prepared QMCSO that requires a plan participant to provide coverage for a dependent child.
(See 29 U.S.C. 1169(a)) A child may no longer be denied insurance coverage due to the child
residing in another state from the insuring parent, or the child not being listed on the parent’s
federal income tax return, for example.
Note: § 44-3,146 (2) i provides that funds deducted from an employee’s paycheck for the
cost of dependent health insurance coverage must stand in line behind monies withheld pursuant
to a standard withholding order for child support. If there is not enough income to go around,
the health insurance stops. You can take steps to prevent this from happening in instances
where having dependent health insurance coverage is more important to the custodial parent than
receiving child support.
CHERAMIE V. HAFEMAN, Neb. Court of Appeals. Filed June 9, 2009. No. A-08-882.
THIS OPINION IS NOT DESIGNATED FOR PERMANENT PUBLICATION AND MAY NOT
BE CITED EXCEPT AS PROVIDED BY NEB. CT. R. APP. P. § 2-102(E). While this case
may not be cited as authority, it is the only case I have found that addresses whether
“medical expenses” includes “dental expenses”. It may provide a cautionary tale to
order drafters….if you are going to spell out what any dependent medical coverage includes,
you better spell out everything it includes.
We determine that the term ―medical expenses‖ as used in the agreement is clear and
unambiguous. Where the language used in the agreement is unambiguous, we are
bound to consider such language from the four corners of the agreement itself, and what
the parties thought the agreement meant is irrelevant. Strunk v. Chromy-Strunk, 270
Neb. 917, 708 N.W.2d 821 (2006), citing Klinginsmith v. Wichmann, 252 Neb. 889,
567 N.W.2d 172 (1997)
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