Under certain circumstances, the Research Foundation (RF) is required by the Employee Retirement and Income Security Act (ERISA) to offer medical benefits to dependent children outside of open enrollment without a waiting period. This document describes the procedure for determining if a medical child support order is qualified under ERISA.
Under the following circumstances, the RF offers medical benefits to children outside of the open enrollment period without a waiting period:
This procedure assists RF benefit administrators in determining if a medical child support order is qualified, and then appropriately responding to such an order. The RF is not required to offer benefits to dependents under a medical child support order that is not qualified.
For a medical child support order to be QMCSO, it must meet all of the following conditions:
If a medical child support order is determined to be a QMSCO, then enroll the alternate recipients in accordance with the procedure relating to that medical plan (Graduate Student or Regular Employee), and notify the sender of the order that the order is qualified (see sample reply letter, referenced below).
If a medical child support order is not qualified, then notify the sender of the order that the order is not qualified and that the alternate recipient(s) will not be enrolled (see sample reply letter, referenced below).
For all medical child support order requests, a reply letter should be issued to the sender of the order. A sample reply letter is provided for responding to the sender of the order. Complete the letter by filling in the appropriate information. Keep a copy of any correspondence for our RF records.
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