Question: We Issued a CS-72 and Received the Plan Administrator Response in Today S Mail

Health Insurance has Options (Dec. 2004)

Question: “We issued a CS-72 and received the Plan Administrator Response in today’s mail. The response indicated that there is more than 1 option available to the NCP, which is now our responsibility to choose the plan for enrollment. Briefings of the 2 options available were provided to us. There is a base plan and a buy-up plan. The base plan has a bigger deductible, higher co-pay, etc. but does not cost as much to the NCP as the buy-up plan. What do we have to consider when choosing the plan to respond to the Administrator? Are there any specific requirements that we must consider?”

Answer: In accordance with the report to Department of Health and Human Services (HHS), published June 2000 by The National Medical Support Notice, 21 Million Children's Health: Our Shared Responsibility, Chapter 4, Implementing a New Tool: The NMSN and Related Issues, Recommendation 38 (best practice), "situations in which the IV-D agency is advised that a choice is required with regard to plan options, the agency should do the following:

·  If there is a Medicaid assignment in effect, the IV-D agency should consult with the custodial parent and the Medicaid agency, review the State's treatment of coverage under child support guidelines, choose the appropriate option consistent with the best interests of the child, and notify the plan.

·  If there is no Medicaid assignment in effect, the IV-D agency should contact the custodial parent regarding the options, review such options in light of the State's treatment of coverage under the child support guidelines, ascertain the custodial parent's choice, and notify the plan."

The custodial parent selects the plan that is the most accommodating to the needs of the child. If the issuing agency fails to contact the plan administrator with a selection, the child is enrolled in a default option, if available.