§ 416 — Elements of support; provisions for accident, life and health insurance benefits

New York § 416

• Jurisdiction: New York
• Law FCT: Family Court Act
• Part 1: Jurisdiction and Duties of Support
• Art. 4: Support Proceedings

Text

§ 416. Elements of support; provisions for accident, life and health\ninsurance benefits. (a) The court may include in the requirements for an\norder for support the providing of necessary shelter, food, clothing,\ncare, medical attention, expenses of confinement, the expense of\neducation, payment of funeral expenses, and other proper and reasonable\nexpenses.\n (b) The court may also order a party to purchase, maintain, or assign\na policy of accident insurance or insurance on the life of either party\nand designate in the case of life insurance, the person or persons on\nwhose behalf the petition is brought or in the case of accident\ninsurance, the insured party as irrevocable beneficiaries during a\nperiod of time fixed by the court. The obligation to provide such\ninsurance shall cease upon the termination of such party's duty to\nprovide support.\n (c) Every support order shall provide that if any legally responsible\nrelative currently, or at any time in the future, has health insurance\nbenefits available that may be extended or obtained to cover any person\non whose behalf the petition is brought, such responsible relative is\nrequired to exercise the option of additional coverage in favor of such\nperson whom he or she is legally responsible to support and to execute\nand deliver to such person any forms, notices, documents, or instruments\nto assure timely payment of any health insurance claims for such person.\n (d) As used in this section, the following terms shall have the\nfollowing meanings: (1) "Health insurance benefits" means any medical,\ndental, optical and prescription drugs and health care services or other\nhealth care benefits that may be provided for a dependent through an\nemployer or organization, including such employers or organizations\nwhich are self insured, or through other available health insurance or\nhealth care coverage plans.\n (2) "Available health insurance benefits" means any health insurance\nbenefits that are reasonable in cost and that are reasonably accessible\nto the person on whose behalf the petition is brought. Health insurance\nbenefits that are not reasonable in cost or whose services are not\nreasonably accessible to such person shall be considered unavailable.\n (3) When the person on whose behalf the petition is brought is a child\nin accordance with subdivision (e) of this section, health insurance\nbenefits shall be considered "reasonable in cost" if the cost of health\ninsurance benefits does not exceed five percent of the combined parental\ngross income. The cost of health insurance benefits shall refer to the\ncost of the premium and deductible attributable to adding the child or\nchildren to existing coverage or the difference between such costs for\nself-only and family coverage. Provided, however, the presumption that\nthe health insurance benefits are reasonable in cost may be rebutted\nupon a finding that the cost is unjust or inappropriate which finding\nshall be based on the circumstances of the case, the cost and\ncomprehensiveness of the health insurance benefits for which the child\nor children may otherwise be eligible, and the best interests of the\nchild or children. In no instance shall health insurance benefits be\nconsidered "reasonable in cost" if a parent's share of the cost of\nextending such coverage would reduce the income of that parent below the\nself-support reserve. Health insurance benefits are "reasonably\naccessible" if the child lives within the geographic area covered by the\nplan or lives within thirty minutes or thirty miles of travel time from\nthe child's residence to the services covered by the health insurance\nbenefits or through benefits provided under a reciprocal agreement;\nprovided, however, this presumption may be rebutted for good cause shown\nincluding, but not limited to, the special health needs of the child.\nThe court shall set forth such finding and the reasons therefor in the\norder of support.\n (e) When the person on whose behalf the petition is brought is a\nchild, the court shall consider the availability of health insurance\nbenefits to all parties and shall take the following action to insure\nthat health insurance benefits are provided for the benefit of the\nchild:\n (1) Where the child is presently covered by health insurance benefits,\nthe court shall direct in the order of support that such coverage be\nmaintained, unless either parent requests the court to make a direction\nfor health insurance benefits coverage pursuant to paragraph two of this\nsubdivision.\n (2) Where the child is not presently covered by health insurance\nbenefits, the court shall make its determination as follows:\n (i) If only one parent has available health insurance benefits, the\ncourt shall direct in the order of support that such parent provide\nhealth insurance benefits.\n (ii) If both parents have available health insurance benefits the\ncourt shall direct in the order of support that either parent or both\nparents provide such health insurance. The court shall make such\ndetermination based on the circumstances of the case, including, but not\nlimited to, the cost and comprehensiveness of the respective health\ninsurance benefits and the best interests of the child.\n (iii) If neither parent has available health insurance benefits, the\ncourt shall direct in the order of support that the custodial parent\napply for the state's child health insurance plan pursuant to title\none-A of article twenty-five of the public health law and the medical\nassistance program established pursuant to title eleven of article five\nof the social services law. A direction issued under this subdivision\nshall not limit or alter either parent's obligation to obtain health\ninsurance benefits at such time as they become available as required\npursuant to subdivision (c) of this section. Nothing in this subdivision\nshall alter or limit the authority of the medical assistance program to\ndetermine when it is considered cost effective to require a custodial\nparent to enroll a child in an available group health insurance plan\npursuant to paragraphs (b) and (c) of subdivision one of section three\nhundred sixty-seven-a of the social services law.\n (f) The cost of providing health insurance benefits or benefits under\nthe state's child health insurance plan or the medical assistance\nprogram, pursuant to subdivision (e) of this section, shall be deemed\ncash medical support, and the court shall determine the obligation of\neither or both parents to contribute to the cost thereof pursuant to\nsubparagraph five of paragraph (c) of subdivision one of section four\nhundred thirteen of this part.\n (g) The court shall provide in the order of support that the legally\nresponsible relative immediately notify the other party, or the other\nparty and the support collection unit when the order is issued on behalf\nof a child in receipt of public assistance and care or in receipt of\nservices pursuant to section one hundred eleven-g of the social services\nlaw, of any change in health insurance benefits, including any\ntermination of benefits, change in the health insurance benefit carrier,\npremium, or extent and availability of existing or new benefits.\n (h) Where the court determines that health insurance benefits are\navailable, the court shall provide in the order of support that the\nlegally responsible relative immediately enroll the eligible dependents\nnamed in the order who are otherwise eligible for such benefits without\nregard to any seasonal enrollment restrictions. The support order shall\nfurther direct the legally responsible relative to maintain such\nbenefits as long as they remain available to such relative. Such order\nshall further direct the legally responsible relative to assign all\ninsurance reimbursement payments for health care expenses incurred for\nhis or her eligible dependents to the provider of such services or the\nparty actually having incurred and satisfied such expenses, as\nappropriate.\n (i) When the court issues an order of child support or combined child\nand spousal support on behalf of persons in receipt of public assistance\nand care or in receipt of services pursuant to section one hundred\neleven-g of the social services law, such order shall further direct\nthat the provision of health care benefits shall be immediately enforced\npursuant to section fifty-two hundred forty-one of the civil practice\nlaw and rules.\n (j) When the court issues an order of child support or combined child\nand spousal support on behalf of persons other than those in receipt of\npublic assistance and care or in receipt of services pursuant to section\none hundred eleven-g of the social services law, the court shall also\nissue a separate order which shall include the necessary direction to\nensure the order's characterization as a qualified medical child support\norder as defined by section six hundred nine of the employee retirement\nincome security act of 1974 (29 USC 1169). Such order shall: (i) clearly\nstate that it creates or recognizes the existence of the right of the\nnamed dependent to be enrolled and to receive benefits for which the\nlegally responsible relative is eligible under the available group\nhealth plans, and shall clearly specify the name, social security number\nand mailing address of the legally responsible relative, and of each\ndependent to be covered by the order; (ii) provide a clear description\nof the type of coverage to be provided by the group health plan to each\nsuch dependent or the manner in which the type of coverage is to be\ndetermined; and (iii) specify the period of time to which the order\napplies. The court shall not require the group health plan to provide\nany type or form of benefit or option not otherwise provided under the\ngroup health plan except to the extent necessary to meet the\nrequirements of a law relating to medical child support described in\nsection one thousand three hundred and ninety-six g-1 of title forty-two\nof the United States code.\n (k) Upon a finding that a legally responsible relative wilfully failed\nto obtain health insurance benefits in violation of a court order, such\nrelative will be presumptively liable for all health care expenses\nincurred on behalf of such dependents from the first date such\ndependents were eligible to be enrolled to receive health insurance\nbenefits after the issuance of the order of support directing the\nacquisition of such coverage.\n