Ohio law requires that all child support orders include a Medical Support Provision.

• The Obligee is presumed to be the appropriate parent to provide health insurance for the child(ren) subject to
  the support order, unless rebutted.

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

The child support order must contain a cash medical support obligation. Cash medical support is an amount, in addition to child support, that must be paid.

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

• Cash medical will be a charging support obligation at all times.

• An order for payment of uninsured medical expenses of the child(ren) will be ordered as well.

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 insurance to the employee is not greater than 5% of the parent’s annual 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.