(A)In accordance
with section 3119.39 of the Revised Code, when a JFS 04036, "Notice of
Medical Support Enforcement Activity" (effective or revised effective date
as identified in rule 5101:12-57-99 of the Administrative Code), is issued and
the health insurance obligor fails to make a timely request for an
administrative hearing, the JFS 04036 becomes a final and enforceable
determination of the child support enforcement agency (CSEA) that issued the
JFS 04036.
(B)A health
insurance obligor who receives an OMB 0970-0222, "National Medical Support
Notice" (as referenced in rule 5101:12-57-99 of the Administrative Code)
(NMSN), or a JFS 04036 may request an administrative mistake of fact hearing
for any of the following reasons:
(1)Error in the
identity of the parties to the support order listed on the NMSN;
(2)Error in the
identity of one or more of the children listed on the NMSN;
(3)The child
support order authorizes the provision of health insurance coverage through an
alternative group policy, contract, or plan and alternative coverage is in
effect;
(4)The coverage
identified in the NMSN is not consistent with the medical support provision in
the child support order, this includes assertions that the insurance is not
reasonable in cost or that primary care services are not accessible; or
(5)The child
support order authorizes the provision of health care coverage through public
health care and such coverage is in effect, as ordered.
(C)In accordance
with section 3119.38 of the Revised Code, the health insurance obligor must
file a written request for an administrative mistake of fact hearing with the
CSEA that issued the notice not later than fourteen days after the date on
which the JFS 04036 is issued.
(D)In accordance
with section 3119.38 of the Revised Code, when the health insurance obligor
makes a timely request for an administrative mistake of fact hearing, the CSEA
shall:
(1)Conduct an
administrative mistake of fact hearing not later than ten days after the date
on which the health insurance obligor files the request for the administrative
mistake of fact hearing; and
(2)Issue the JFS 03399, "Notice of Administrative Mistake of Fact Hearing" (effective
or revised effective date as identified in rule 5101:12-57-99 of the
Administrative Code), to the health insurance obligor and any other individual
the CSEA determines appropriate not later than five days before the date on
which the administrative mistake of fact hearing is to be conducted.
(E)In accordance
with section 3119.41 of the Revised Code, when an administrative mistake of
fact process is pending, the employer is required to continue the withholding
of amounts for health insurance pursuant to the NMSN.
(F)In accordance
with section 3119.38 of the Revised Code, at the administrative hearing, the
CSEA shall determine whether there is a mistake of fact in the NMSN.
(G)After the
hearing has been held, the CSEA shall issue the JFS 04037, "Medical
Support Enforcement Administrative Mistake of Fact Hearing Decision"
(effective or revised effective date as identified in rule 5101:12-57-99 of the
Administrative Code), to the health insurance obligor. When the health
insurance obligor is the non-custodial parent, the CSEA shall send a copy of
the JFS 04037 to the custodial parent.
(H)In accordance
with section 3119.41 of the Revised Code:
(1)When the CSEA
determines that no mistake of fact exists, the NMSN shall remain in effect.
(2)When the CSEA
determines that a mistake of fact does exist, the CSEA shall take whatever
action is necessary regarding the NMSN, which may
include issuing a corrected NMSN or terminating the NMSN
in accordance with rule 5101:12-57-10.6 of the Administrative Code.
(I)When an
administrative mistake of fact hearing determines that the person named as the
health insurance obligor was named in error and premiums have been deducted,
the CSEA shall not address the decision formatter of reimbursement in the
decision.
(J)In accordance
with section 3119.38 of the Revised Code, the administrative mistake of fact
hearing determination is final unless, within fourteen days after the CSEA
issues the JFS 04037, the health insurance obligor files a written motion with
the court of jurisdiction in the county in which the support order is
administered for a hearing to determine whether there is still a mistake of
fact in the NMSN.
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: 3119.38, 3119.39, 3119.41.
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, 01/15/2017, 02/11/2019,
01/15/2020