(A)In accordance
with section 3119.37 of the Revised Code, upon receipt of the OMB 0970-0222,
"National Medical Support Notice" (as referenced in rule
5101:12-57-99 of the Administrative Code), (NMSN) and the JFS 03377,
"Employer/Health Plan Administrator Health Insurance Verification
Request" (effective or revised effective date as indentified identified in rule 5101:12-57-99 of the Administrative
Code), the health plan administrator is required to:
(1)Complete and
return part B of the NMSN to the child support enforcement agency (CSEA) within
forty business days of the date of the NMSN; and
(2)Comply with the
enrollment requirements in accordance with the instructions contained in the
NMSN.
(B)When there is
more than one health coverage option available under the plan and the health
insurance obligor is not enrolled in any of the options:
(1)The health plan
administrator is required to attach to part B copies of applicable summary plan
descriptions or other documents that describe available coverage, including the
additional participant contribution necessary to obtain coverage for the child
under each option and whether there is a limited service area for any option.
(2)When the health
plan has a default option and the CSEA fails to notify the health plan
administrator of the health coverage selection within twenty business days, the
health plan administrator is required to enroll the child in the health plan's
default option.
(C)After the child
has been enrolled in a health plan option, the health plan administrator is
required to complete and return the JFS 03377 to the CSEA.
(D)In accordance
with section 3119.422 of the Revised Code, nothing in rule 5101:12-47-01,
5101:12-57-01, or 5101:12-57-10 to 5101:12-57-10.6 of the Administrative Code
shall be construed to require the health plan administrator to accept for
enrollment any child who does not meet the underwriting standards of the health
insurance or health care policy, contract, or plan for which application is
made.
Effective: 6/1/2022
Five Year Review (FYR) Dates: 2/16/2022 and 02/16/2027
Certification: CERTIFIED ELECTRONICALLY
Date: 05/17/2022
Promulgated Under: 119.03
Statutory Authority: 3119.51
Rule Amplifies: 3119.37, 3119.422
Prior Effective Dates: 01/07/1985, 08/01/1986, 12/01/1987,
12/20/1988, 09/01/1989, 08/01/1990, 06/01/1991, 11/01/1991, 07/15/1992,
04/01/1993, 01/01/1998, 10/02/2003, 01/01/2007, 05/01/2012, 01/15/2017