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A QMCSO must be issued by a court or governement agency, such as the office of child support enforcement. A state court or agency may require an ERISA-covered health plan to provide health benefits coverage to children by issuing a medical child support order. The group health plan must determine whether the medical child support order is “qualified.” The plan should pay benefits to the alternate recipient, the custodial parent, or the provider of health services to the child notwithstanding plan terms that may require benefit payments be made to the participant.
The following is an example of a court order requiring a health plan to enroll a child with a legal guardian:http://www.jdbar.com/Forms/Qualified_Medical_Child_Support_Order.pdf
Please see the following recently updated Compliance Guide For Qualified Medical Child Support Orders from the Department of Labor:http://www.dol.gov/ebsa/publications/qmcso.html