Ohio law requires that all child support orders include both:

• An amount of child support to be paid when private health insurance is being provided

• An amount of child support to be paid when private health insurance is not being provided

Fully subsidized coverage through Ohio Medicaid does not meet the requirements to provide private health insurance.

The child support order must also contain a cash medical support obligation. Cash medical support is an amount, in addition to child support, that must be paid when no private health insurance is provided.

Support orders must also include a provision that addresses the health insurance needs of the child by including:

• An order for one or both of the parents to provide private health insurance coverage for the child

• An order for payment of uninsured medical expenses of the child

If neither parent has health insurance available, both parents are ordered to report any coverage that becomes available to them as soon as it is available.

Reasonable Cost

When a parent has access to health insurance coverage for the child, the court or the CSEA cannot order the parent to obtain the insurance coverage unless it is reasonable in cost. The coverage is determined to be reasonable in cost if the cost of the family plan minus the cost of employee-only coverage is not greater than 5% of the parent’s gross income. A parent can agree to provide the coverage if it exceeds reasonable cost if they choose to do so.

The CSEA is required to enforce health insurance orders. The CSEA will issue a National Medical Support Notice (NMSN) to any employer of a person who is ordered to provide health insurance coverage for their child. The NMSN orders the employer to enroll the child in the health insurance plan available to the parent ordered to provide the coverage. The employer is required to comply with the NMSN and must enroll the child, if the insurance coverage is determined to be reasonable in cost, and does not need the consent of the parent to enroll the child in the coverage even if the employer's open enrollment period is not active.