CSPMTL 96 (Medical Support Rules and Forms)
Child Support Program Manual Transmittal Letter No. 96
December 4, 2014
TO: All Child Support Program Manual Holders
FROM: Cynthia C. Dungey, Director
SUBJECT: Medical Support Rules and Forms

The Office of Child Support (OCS) has proposed to rescind, revise, and adopt new the following rules and forms. The rules have been reviewed in accordance with section 119.032 of the Revised Code, which requires the review of all state agency rules within a five-year period.

OCS has proposed to rescind the following rule:

Rescinded RuleTitlesPrior Effective Date of RuleEffective Date of Rescission
5101:12‑57‑08Medical support mistake of fact hearing process.3/1/200901/01/2015
This rule describes the medical support mistake of fact hearing process which is only available to an individual whose child support order was issued or modified in accordance with section 3119.30 of the Revised Code as adopted under Amended Substitute House Bill 119 of the 127th General Assembly. This rule has been rescinded and replaced by a new rule with the same rule number and title because more than fifty percent of this rule is being restructured to a new format for clarity.

OCS has proposed to revise the following rules:

Amended RuleAmended Rule TitlePrior Effective Date of RuleEffective Date of Amendment
5101:12‑47‑01Medical support provisions.3/1/200901/01/2015
This rule defines terms used throughout division 5101:12 of the Administrative Code. Changes from the existing rule include: revised paragraph (F) to remove the word caretaker from the definition of "Health insurance obligor" to be consistent with the federal definition.
This rule is authorized under ORC section 3119.51; and amplifies ORC section(s) 3119.29, 3119.30, 3119.31, 3119.32
5101:12‑47‑01.1Medical support provisions for health insurance and uncovered expenses.3/1/200901/01/2015
This rule describes an action or proceeding in which a child support enforcement agency (CSEA) issues or modifies a child support order. Each party to the child support order is required to provide a list of any available private group health insurance policies, contracts, or plans to the CSEA. Changes from the existing rule include: revised paragraph (E) by removing the header to be consistent with the format of the rule.
This rule is authorized under ORC section 3119.51; and amplifies ORC section(s) 3119.30, 3119.31, 3119.32
5101:12‑47‑01.2Medical support provision for cash medical support.7/1/201301/01/2015
This rule describes the CSEA's process on how to calculate the cash medical support amount in accordance with the Ohio child support guidelines as described in rule 5101:12‑45‑10 of the Administrative Code. Changes from the existing rule include: revised paragraph (A) by writing our agency full title since this is the first time referenced in this rule, also revised paragraph (E)(2) to update the format to address the addition of the forms rule.
This rule is authorized under ORC section 3119.51; and amplifies ORC section(s) 3119.30, 3119.302
5101:12‑57‑01.1Enforcement of order to report private health insurance3/1/200901/01/2015
This rule applies only to child support orders issued or modified in accordance with section 3119.30 of the Revised Code as adopted under Amended Substitute House Bill 119 of the 127th General Assembly. Changes from the existing rule include: revised multiple paragraphs to include the new language of the forms rule.
This rule is authorized under ORC section 3119.51; and amplifies ORC section 3119.30
5101:12‑57‑01.2Enforcement of cash medical support obligation.3/1/200901/01/2015
This rule describes the requirements of the CSEA during any period in which an obligor is ordered to pay cash medical support because private health insurance coverage for the child as ordered is no longer available to the health insurance obligor. Changes from the existing rule include: revised paragraph (C)(1) to include the new language of the forms rule.
This rule is authorized under ORC section 3119.51; and amplifies ORC section 3119.30

OCS has proposed the following new rules:

New RulesNew Rules TitlesEffective Date of Rules
5101:12‑57‑08Medical support mistake of fact hearing01/01/2015
This rule describes the medical support mistake of fact hearing process which is only available to an individual whose child support order was issued or modified in accordance with section 3119.30 of the Revised Code as adopted under Amended Substitute House Bill 119 of the 127th General Assembly. This rule has been adopted as new because more than fifty percent of the format changes for clarity and flow. Additionally, multiple paragraphs were revised to include the new language of the forms rule.
This rule is authorized under ORC section 3119.51; and amplifies ORC section 3119.30
5101:12‑47‑99Chapter 5101:12-47 form - medical support provisions for cash medical.01/01/2015
This is a new rule that contains a compilation of forms within division 5101:12 of the Administrative Code, but first cited within Chapter 5101:12-47 of the Administrative Code.
This rule is authorized by ORC section 3125.25.
5101:12‑57‑99Chapter 5101:12-57 forms - enforcement of medical support provisions.01/01/2015
This is a new rule that contains a compilation of forms within division 5101:12 of the Administrative Code, but first cited within Chapter 5101:12-57 of the Administrative Code.
This rule is authorized by ORC section 3125.25.

OCS has proposed to revise the following forms:

Revised FormRevised Form TitlePrior Effective DateEffective Date of Revision
JFS 03377Employer/Health Plan Administrator Health Insurance Verification Request5/200501/2015
This form is used to notify the CSEA if the employee is currently enrolled in health insurance or in the process of being enrolled in health insurance.
The changes made to this form were to add the title of Ohio Department of Job and Family Services to the form therefore becoming in compliance with requirements of IPP 4301 forms design standards.
JFS 03399Notice of Administrative Mistake of Fact Hearing2/200301/2015
This notice is used by the CSEA to inform parties of an upcoming hearing and what is expected of them during the hearing.
The changes made to this form were to add the title of Ohio Department of Job and Family Services to the form therefore becoming in compliance with requirements of IPP 4301 forms design standards.
JFS 04031Notice Regarding Cash Medical Support Order and Request for a Medical Support Mistake of Fact Hearing8/200801/2015
This form is used by the CSEA to notify the parties when private health insurance that is accessible and reasonable in cost becomes available to the Health Insurance Obligor. The Health Insurance Obligor shall be required to provide private health insurance coverage for the child(ren) named in the order and the cash medical support obligation for the child(ren) named in the order shall cease while private health insurance coverage is being provided. This form also includes a Request for a Medical Support Mistake of Fact Hearing.
The changes made to this form were to add the title of Ohio Department of Job and Family Services to the form therefore becoming in compliance with requirements of IPP 4301 forms design standards.
JFS 04032Notice to Provide Cash Medical Support and Request for a Medical Support Mistake of Fact Hearing8/200801/2015
This form is used by the CSEA to notify the parties during any period in which private health insurance that is reasonable in cost and accessible is not being provided for the child(ren) as ordered. The Child Support Obligor is required to pay cash medical support and both parties are required to immediately report to the CSEA any available private health insurance coverage for the child(ren). This form also includes a Request for a Medical Mistake of Fact Hearing.
The changes made to this form were to add the title of Ohio Department of Job and Family Services to the form therefore becoming in compliance with requirements of IPP 4301 forms design standards.
JFS 04033Notice to Provide Private Health Insurance and Request for a Medical Support Mistake of Fact Hearing8/200801/2015
This form is used by the CSEA to notify the parties when private health insurance that is accessible and reasonable in cost becomes available to one of the parties, that party shall be deemed the Health Insurance Obligor and be required to provide private health insurance coverage for the child(ren) named above and the cash medical support obligation for the child(ren) named above shall cease while private health insurance coverage is being provided as ordered. This form also includes a Request for a Medical Mistake of Fact Hearing.
The changes made to this form were to add the title of Ohio Department of Job and Family Services to the form therefore becoming in compliance with requirements of IPP 4301 forms design standards.
JFS 04034Notice of Selection of Health Plan Options12/200501/2015
The CSEA uses this notice to inform the party that a selection from available health insurance plan options has been made.
The changes made to this form were to add the title of Ohio Department of Job and Family Services to the form therefore becoming in compliance with requirements of IPP 4301 forms design standards.
JFS 04035Notice of Available Health Plan Options and Health Insurance Obligee's Selection of Health Plan Options2/200601/2015
This notice is used by the CSEA to inform the party about available health plan options. Once a selection is made, the party has the responsibility to return the Health Insurance Obligee's Selection of Health Plan Oprtions to the CSEA.
The changes made to this form were to add the title of Ohio Department of Job and Family Services to the form therefore becoming in compliance with requirements of IPP 4301 forms design standards.
JFS 04036Notice of Medical Support Enforcement Activity and Request for an Administrative Mistake of Fact Hearing1/200601/2015
This notice is used by the CSEA to inform the party that since they were determined by a court or CSEA to be the Health Insurance Obligor a National Medical Support Notice was sent to their employer to enroll the child(ren) listed on the order in any available health insurance plan and to withhold premiums for health insurance coverage in accordance with section 3119.33 of the Revised Code. Attached is also a Request for an Administrative Mistake of Fact Hearing.
The changes made to this form were to add the title of Ohio Department of Job and Family Services to the form therefore becoming in compliance with requirements of IPP 4301 forms design standards.
JFS 04037Medical Support Enforcement Administrative Mistake of Fact Hearing Decision2/200601/2015
This form is used by the CSEA to inform the party of the decision made during the Medical Support Enforcement mistake of fact hearing.
The changes made to this form were to add the title of Ohio Department of Job and Family Services to the form therefore becoming in compliance with requirements of IPP 4301 forms design standards.
JFS 04098Notice Regarding National Medical Support Notice Withholding Requirements8/200801/2015
This form is used by the CSEA to inform a party's employer that their employee has satisfied the requirements of the medical support order and is no longer required by the courts or CSEA to continue the coverage.
The changes made to this form were to spell out the title from NMSN to National Medical Support Notice to be consistence with other forms in this package.
JFS 05050Schedule of Cash Medical Support Obligations7/01/20137/01/2014
The cash medical support schedule is used by all Ohio courts and child support enforcement agencies when calculating the amount of cash medical support to be paid pursuant to a child support order.
Changes from the previous version include: Modified the income ranges and per child expenditure amounts based on the data published by the United States Department of Agriculture: "Expenditures on Children by Families 2012", Estimated annual expenditures on a child by husband-wife families, urban Midwest, 2012.
JFS 07053Notice of Medical Support Mistake of Fact Hearing8/200801/2015
This form is used by the CSEA to inform the parties that the CSEA received a request for a Medical Support Mistake of Fact Hearing and the date of the hearing.
The changes made to this form were to add the title of Ohio Department of Job and Family Services to the form therefore becoming in compliance with requirements of IPP 4301 forms design standards.
JFS 07058Medical Support Mistake of Fact Hearing Determination8/200801/2015
This form is used by the CSEA to inform the party of the decision made during the Medical Support mistake of fact hearing.
The changes made to this form were to add the title of Ohio Department of Job and Family Services to the form therefore becoming in compliance with requirements of IPP 4301 forms design standards.

INSTRUCTIONS:

When the CSPMTL is published, the CSPM will be updated as follows:

  • A rescinded rule will be moved from the CSPM to the OAC Archive section of the eManuals.
  • An amended rule will be inserted and the previous version will be moved to the OAC Archive section of the eManuals.
  • An adopted rule will be inserted in the CSPM.
  • A revised form will be replaced with the amended form.

The rules and forms in the CSPM can be accessed at:

http://emanuals.jfs.ohio.gov.

Forms can also be accessed on the ODJFS Forms Central InnerWeb page at:

http://www.odjfs.state.oh.us/forms/inner.asp

or on the ODJFS Forms Central Internet page at:

http://www.odjfs.state.oh.us/forms/inter.asp

INSTRUCTIONS for CSEA INTERNAL PROCEDURAL HANDBOOK:

Paragraph (I)(1) of OAC rule 5101:12-1-01 states that, whenever a program change requires modification of local procedures, the CSEA is required to revise its internal procedural handbook and submit the revision to OCS within thirty days of the revision. The CSEA should carefully review the rules contained in this CSPMTL to determine whether they require the CSEA to update its internal procedural handbook.