Medical insurance

Federal law requires that the Child Support Enforcment Agency (CSEA) must petition the court or administrative authority to include private health insurance that is accessible to the child(ren), as defined by the State, and is available to the parent responsible for providing medical support at a reasonable cost, in new or modified court or administrative orders for support.  45 Code of Federal Regulations (C.F.R.) § 303.31(b)(1).  The 2014 Hawaiʻi Child Support Guidelines adopts a reasonableness standard of 10% of the parent’s net income from the Guidelines’ Table.

The Department of Human Services automatically refers all cases where a child receives Medicaid/QUEST health insurance benefits to the CSEA to establish a medical support order requiring the noncustodial parent to provide private medical insurance coverage for the child.

The proposed administrative order may require that the noncustodial/responsible parent and/or the custodial parent provide health insurance (or cash medical support) for the child(ren) and submit written proof of coverage and a medical identification card to the CSEA.
Issues that may be addressed at a hearing regarding medical insurance coverage include:

    • Whether the child is enrolled in Medicaid/QUEST (public health insurance benefits)
    • Which party is obligated by the current child support order to provide private medical insurance coverage for the child
    • the cost of adding the child(ren) to the existing coverage or the difference between self-only and family coverage
    • whether private health insurance is available to either parent
    • whether private health insurance is reasonable in cost
    • whether private health insurance is accessible to the child(ren)

The Hearings Officer will determine whether evidence presented at the hearing is relevant to the proceeding.  Even if the custodial parent is obligated by the applicable child support order to provide medical insurance coverage, if he or she subsequently enrolls the child in Medicaid/QUEST public health insurance, at the hearing the order may be changed to require the responsible parent to provide private medical insurance for the child or for one of the parents to contribute monthly cash contributions to help cover the cost of the Medicaid/QUEST insurance.

To prepare for a hearing the party should read thoroughly all documents he or she receives from the CSEA and the OCSH.  These documents will explain the action the CSEA is proposing and what laws and/or regulations govern it.

See also the Preparing for Your Hearing section of this website regarding documents parties may want to present at the administrative hearing.