Summary Plan Description

Qualified Medical Child Support Orders

The plan recognizes Qualified Medical Child Support Orders (QMCSO) and enrolls your natural dependent children, adopted dependent children, and dependent children placed with you in anticipation of adoption as directed by the order.

A QMCSO is any judgment, decree or order (including a domestic relations settlement agreement) issued by an administrative agency under applicable state law which:

  • Provides child support or health benefit coverage to a dependent child; or
  • Enforces a state law relating to medical child support pursuant to Section 1908 of the Social Security Act, which provides in part that if you do not enroll the dependent child, then the non-employee parent or state agency may enroll the child.

To be qualified, a Medical Child Support Order must clearly specify:

  • Your name and last known mailing address;
  • The name and mailing address of each dependent child covered or the name and mailing address of the state official issuing the order;
  • A description of the type of coverage to be provided by the plan to each such dependent child;
  • The period of coverage to which the order applies; and
  • The name of each plan to which the order applies.

A Medical Child Support Order will not qualify as a QMCSO if it would require the plan to provide any type or form of benefit or any option not otherwise provided under this plan, except to the extent necessary to comply with Section 1908 of the Social Security Act.

Payment of plan benefits under a QMCSO is made to the child or custodial parent or legal guardian if so required by the QMCSO.

No eligible dependent child covered by a QMCSO will be denied enrollment in the plan on grounds that the child is not claimed as a dependent on your Federal income tax return or does not reside with you.

If a proposed or final order is received, Carpenters Trusts will notify you and each child named in the order. The order will then be reviewed to determine if it meets the definition of a "Qualified Medical Child Support Order." A properly completed National Medical Support Notice issued by a state agency shall be deemed to be a QMCSO. The order will then be reviewed to determine if it meets the definition of a QMCSO. Within a reasonable period of time, you and each child named in the order will be notified of the decision. A notice will also be sent to each attorney or other representative named in the order or accompanying correspondence.

If the order is not qualified, the notice will give the specific reason for the decision. The party or parties filing the order will be given an opportunity to correct the order. If the order is qualified, the notice will give instructions for enrolling each child named in the order. A copy of the entire QMCSO and any required self-payments pursuant to an order will be subject to all provisions applicable to dependent coverage under the plan.