PRINTER'S NO. 2706
No. 2165 Session of 1991
INTRODUCED BY STETLER, BATTISTO, DeWEESE, ITKIN, FAIRCHILD,
HARPER, MUNDY, FAJT, HANNA, TIGUE, KENNEY, TRELLO, PESCI,
STABACK, STURLA, KRUSZEWSKI, PISTELLA, BELFANTI, BILLOW,
BELARDI, CAPPABIANCA, SALOOM AND PETRARCA, NOVEMBER 13, 1991
REFERRED TO COMMITTEE ON AGING AND YOUTH, NOVEMBER 13, 1991
AN ACT
1 Amending Title 23 (Domestic Relations) of the Pennsylvania
2 Consolidated Statutes, further providing for medical support
3 for children.
4 The General Assembly of the Commonwealth of Pennsylvania
5 hereby enacts as follows:
6 Section 1. Section 4324 of Title 23 of the Pennsylvania
7 Consolidated Statutes is amended to read:
8 § 4324. Inclusion of medical support.
9 [In addition to periodic support payments, the court may
10 require that an obligor pay a designated percentage of a child's
11 or spouse's reasonable and necessary health care expenses. If
12 health care coverage is available through an obligor or obligee
13 at no cost as a benefit of employment or at a reasonable cost,
14 the court shall order an obligor or obligee to provide or extend
15 health care coverage to a child or spouse. Upon failure of the
16 obligor to make this payment or reimburse the custodial parent
17 or spouse and after compliance with procedural due process
1 requirement, the court shall treat the amount as arrearages.]
2 (a) General rule.--In every action to establish or modify an
3 order which requires the payment of child support, the court
4 shall ascertain the ability of each parent to provide medical
5 care for the children of the parties. The court shall order one
6 or more of the following:
7 (1) In addition to periodic support payments, the court
8 may require that an obligor pay a designated percentage of a
9 spouse's reasonable and necessary health care expenses.
10 Further, the court shall require that either parent or both
11 parents provide insurance coverage for a child, if such
12 insurance coverage is available to that parent on a group
13 basis through an employer or other entity.
14 (2) If similar insurance coverage is available to both
15 parents, the court shall order the child to be insured under
16 the insurance coverage which provides more comprehensive
17 benefits. If such insurance coverage is not available at the
18 time of the entry of the order, the order shall require that,
19 if such coverage thereafter becomes available to either
20 party, that party shall promptly notify the other party of
21 the availability of insurance coverage for the child.
22 (3) If the court finds that insurance coverage is not
23 available to either parent on a group basis through an
24 employer or other entity, or that the group insurer is not
25 accessible to the parties, the court shall order either
26 parent or both parents to obtain insurance coverage which is
27 otherwise available at a reasonable cost.
28 (4) Based upon the respective ability of the parents to
29 pay, the court may order either parent or both parents to be
30 liable for reasonable and necessary medical care for a child.
19910H2165B2706 - 2 -
1 The court shall specify the proportion of the medical care
2 for which each party shall be responsible.
3 (5) The court shall also determine the amount of the
4 annual deductible on insurance coverage which is attributable
5 to each child and designate the proportion of the deductible
6 which each party shall pay.
7 (b) Proof of insurance.--Within 30 days after the entry of
8 an order requiring the obligated parent or parents to provide
9 insurance coverage for any child, that parent shall submit to
10 the obligor written proof that the insurance has been obtained
11 or that an application for insurance has been made. Such proof
12 of insurance coverage shall consist of, at a minimum:
13 (1) the name of the insurer;
14 (2) the policy number;
15 (3) an insurance card;
16 (4) the address to which all claims should be mailed;
17 (5) a description of any restrictions on usage, such as
18 prior approval for hospital admission and the manner in which
19 to obtain the approval;
20 (6) a description of all deductibles; and
21 (7) five copies of claim forms.
22 (c) Notice to employer.--The obligated parent of the child
23 shall send the obligor's employer or the insurer each child's
24 address and notice that the obligor will be submitting claims on
25 behalf of each child. Upon receipt of the notice or an order for
26 insurance coverage under this section, the obligated parent's
27 employer or other entity shall, upon the request of the obligor,
28 release information on the coverage for the children, including
29 the name of the insurer.
30 (d) Limitation on order.--A copy of the court order for
19910H2165B2706 - 3 -
1 insurance coverage shall not be provided to the obligated
2 parent's employer or other entity or the insurer unless ordered
3 by the court, or unless:
4 (1) the obligated parent, within 30 days of receiving
5 effective notice of the court order, fails to provide to the
6 obligor of the child written proof that the insurance has
7 been obtained or that an application for insurance has been
8 made;
9 (2) the obligor of the child serves written notice by
10 mail at the obligated parent's last known address of
11 intention to enforce the order requiring insurance coverage
12 for the child; and
13 (3) the obligated parent fails within 15 days after the
14 mailing of the notice to provide written proof to the obligor
15 that the child has insurance coverage.
16 (e) Response to order.--Upon service of the order requiring
17 insurance coverage for each child, the employer or other entity
18 shall enroll the child as a beneficiary in the group insurance
19 plan and withhold any required premium from the obligated
20 parent's income or wages.
21 (1) If more than one plan is offered by the employer or
22 other entity, the child shall be enrolled in the most
23 comprehensive plan otherwise available to the obligated
24 parent at a reasonable cost.
25 (2) Insurance coverage for the child which is ordered
26 pursuant to the provisions of this section shall not be
27 terminated except as provided in subsection (g).
28 (f) Authorization to insurers.--The signature of the obligor
29 shall constitute a valid authorization to the insurer for the
30 purposes of processing an insurance payment to the provider of
19910H2165B2706 - 4 -
1 medical care for the child.
2 (1) No insurer or employer or other entity in this
3 Commonwealth may refuse to honor a claim for a covered
4 service when the obligor or the obligated parent submits
5 proof of payment for medical bills for the child.
6 (2) The insurer shall reimburse the obligor or the
7 obligated parent who submits copies of medical bills for the
8 child with proof of payment.
9 (3) All insurers in this Commonwealth shall provide
10 insurance coverage for the child of a covered employee
11 notwithstanding the amount of support otherwise ordered by
12 the court and regardless of the fact that the child may not
13 be living in the home of the covered employee.
14 (g) Insurance termination.--When an order for insurance
15 coverage for a child pursuant to this section is in effect and
16 the obligated parent's employment is terminated, or the
17 insurance coverage for the child is denied, modified or
18 terminated, the insurer shall, within ten days after the notice
19 of change in coverage is sent to the covered employee, notify
20 the obligor of the child and provide an explanation of any
21 conversion privileges available from the insurer.
22 (h) Duration of coverage.--A child of an obligated parent
23 shall remain eligible for insurance coverage until the child is
24 emancipated or until the insurer under the terms of the
25 applicable insurance policy terminates the child from coverage,
26 whichever is later in time, or until further order of the court.
27 (i) Enforcement of order.--If the obligated parent fails to
28 comply with the order to provide insurance coverage for the
29 child, the court shall:
30 (1) hold the obligated parent in contempt for failing or
19910H2165B2706 - 5 -
1 refusing to provide the insurance coverage;
2 (2) enter an order for a sum certain against the
3 obligated parent for the cost of medical care for the child
4 and any insurance premiums paid or provided for the child
5 during any period in which the obligated parent failed to
6 provide insurance coverage; and
7 (3) upon failure of the obligor to make this payment or
8 reimburse the custodial parent or spouse and, after
9 compliance with procedural due process requirement, the court
10 shall treat the amount as arrearages.
11 (j) Definitions.--As used in this section, the following
12 words and phrases shall have the meanings given to them in this
13 subsection:
14 "Child." A child to whom a duty of child support is owned.
15 "Insurance coverage." Coverage for medical, dental,
16 orthodontic, optical, psychological, psychiatric or other health
17 care service for any child in need of child support.
18 "Insurer." Any company, trust or other entity which provides
19 insurance coverage.
20 "Medical care." Medical, dental, orthodontic, optical,
21 psychological, psychiatric or other health care service for
22 children in need of support.
23 "Obligated parent." A natural or adoptive parent who is
24 required by agreement or order to pay for insurance coverage and
25 medical care, or some portion thereof, for his or her child.
26 "Obligor." A parent, legal guardian or other third party
27 appointed by court order as an obligor of a child for whom child
28 support is ordered.
29 Section 2. This act shall apply to all support orders or to
30 modifications of support orders entered on or after the
19910H2165B2706 - 6 -
1 effective date of this act.
2 Section 3. This act shall take effect in 90 days.
H1L23RZ/19910H2165B2706 - 7 -