FAQ’s – Medical Support
1. What do I do if the obligor does not make enough to withhold for both child support and medical coverage?
If the total to be withheld for both child support and medical support exceeds the CCPA limits, you must follow the prioritization required under state law in the state where the employee is employed to determine whether cash child support or medical support should be paid first. The total amount for both the cash child support plus the health insurance premium must fall within the CCPA limits.
West Virginia law requires that priority be given to payment of the cash child support before deducting for the health insurance premium. The total amount withheld (the medical insurance premium plus the amount withheld for financial support) is limited under the Consumer Credit Protection Act (CCPA). The CCPA limits are based on the employee’s disposable income--the income that remains after federal, state, and local withholding taxes, and Social Security taxes (FICA) are deducted. Deductions for Individual Retirement Accounts (IRAs), medical expense accounts, etc. do not reduce disposable income.
The withholding limits for the child(ren)’s portion of the medical insurance premium range from 50% – 65% of the employee’s disposable income. The West Virginia CCPA limits for withholding cash child support range from 40 – 55% of the employee’s disposable income. (The CCPA limit for withholding cash child support for an individual employee is listed on that employee’s Order/Notice to Withhold for Child Support under the section labeled "Remittance Information".) West Virginia limitations are:
- 40% (an additional 10% if medical coverage is ordered) of disposable income if an employee has a second family;
- 45% (an additional 10% if medical coverage is ordered) of disposable income if an employee has a second family and has arrearages that are 12 or more weeks overdue;
- 50% (an additional 10% if medical coverage is ordered) of disposable income if an employee has no second family; or
- 55% (an additional 10% if medical coverage is ordered) of disposable income if an employee has no second family and has arrearages that are 12 or more weeks overdue.
These withholding limitations do not apply to bonuses. The employer is to withhold and remit 50% of any bonus to the BCSE up to the amount of the total arrearage. Bonus checks should be reported to the Employer Relations unit electronically or by fax to 304-558-1487. (Put link to "Notice of Intent to Distribute Lump Sum Payments/Bonus Checks” form here) An Income Withholding Notice/Order will be mailed or faxed informing you of the appropriate amount to be withheld on a case by case basis.
2. What is considered the “child(ren)’s portion” of the medical insurance premium?
The amount of the employee contribution necessary for coverage of the child(ren).
If the employee has single coverage for himself (or if the employee has no coverage but must also be enrolled in order to enroll the children), then the child(ren)'s portion would be the difference between the cost of the "family" plan versus the employee only coverage.
If the employee already has "family" plan coverage and no additional contribution is necessary to enroll the child(ren), the child(ren)'s portion would be zero.
If there is an additional charge for each person added, then the child(ren)'s contribution would be the additional charge times the number of children to be added.
3. What do I do if the employee’s income varies and drops below the limits for withholding the insurance premium?
If the employer cannot withhold the health insurance premiums from an employee’s pay, it is the employee’s responsibility to pay his own health insurance premiums, or to notify the child support enforcement agency and seek a modification of his medical support order. When an employee’s income is not sufficient for the deduction of health insurance premiums and the employee does not pay on his own, you should complete item number 5 on the Employer Response form and send the form to the Issuing Agency. Employers are not expected to enroll and disenroll the children on a month-to-month basis due to the employee’s fluctuating income.
4. Can I still require a Qualified Medical Support Court Order or must I accept the National Medical Support Notice (NMSN)?
The NMSN complies with section 609 (a)(3) and (4) of ERISA, which pertains to informational requirements and restrictions against requiring new types or forms of benefits. An appropriately completed NMSN is considered a "Qualified Medical Child Support Order," or QMCSO, and as such must be honored by all employers' group health plans.
If determined that a specific Notice does not constitute a Qualified Medical Support Court Order (QMSCO) (perhaps there is some missing required information for that particular notice), the Plan Administrator must complete the appropriate response on Part B - Plan Administrator of the National Medical Support Notice and send it to the Issuing Agency, and inform the non-custodial parent, custodial parent and children of the specific reasons for the determination.
5. Does the National Medical Support Notice (NMSN) apply to unions who provide insurance coverage to members, either as a benefit upon payment of union dues or available at a group rate to members who choose to enroll?
Yes. If an employer receives a NMSN for an employee who is a union member, the employer should forward the NMSN to the union.