Years ago, the Legislature placed the responsibility for carrying health insurance for a child on the child support obligor, typically the noncustodial parent.

In practice, as the costs of health care rose along with co-pays and deductibles, as dental and vision insurance became available, as parents lost employment or health coverage in group plans covered less and less, and as the number families with two employed parents rose, both with access to group health insurance --  more and more separated parents began to negotiate who would carry the coverage or which type of coverage each would carry, and how much each party would pay towards premiums and out-of-pocket expenses.

As of January 1, 2007, the Legislature authorized the Court to exercise decision-making over more aspects of health insurance than in the past, basically permitting Courts to compare all policies available to the children. This change was part of the overhaul of the child support guidelines.

The Court must order the person currently carrying the health insurance for the child to continue carrying it unless:

1. The parents agree otherwise.
2. One parent requests a change and the Court determines that other health care coverage is more appropriate.

In evaluating the available policies, the Court is directed to consider the following factors:

1. Is the coverage accessible? The statute defines accessible as “if the …child can obtain services from a health plan provider with reasonable effect by the parent with whom the …child resides.” There is a presumption of accessibility in three circumstances:

a.      Primary care coverage is available within 30 minutes or 30 miles of the joint child’s residence and special care is available within 60 minutes or six miles of the joint child’s residence.

b.      The coverage is available through an employer and the employee can be expected to remain employed for a reasonable amount of time; and

c.       No pre-existing conditions exist to delay coverage unduly.

2. Is the coverage comprehensive? Health care coverage for a child is presumed to be comprehensive if it includes medical and hospital care and provides for preventive, emergency, acute and chronic care. If both parents have health care coverage which meets these basic requirements, then the Court must determine which of the two policies is more comprehensive by looking at additional coverages such as basic dental, orthodontic, optical, mental health and substance abuse.

3. Is the coverage affordable? This determination is left to the Court’s discretion in determining if the cost is “reasonable.”

4. Does the child have any special needs? While not stated in the statute, presumably the Court is to consider the availability and extent of coverage for any health needs resulting from the special needs.

If both parties’ coverage is comparable in accessibility and comprehensiveness, then there is a presumption that the least costly health insurance is appropriate for the child.

If both parties’ coverage is appropriate (i.e., of about the same cost), then the Court is required to order the parent with whom the child resides to carry the health coverage except in certain circumstances.

If only one parent has appropriate coverage available, then the Court is required to order that parent to carry the coverage.       

Rules for other situations such as neither party having insurance and factors for overcoming presumptions are also included in the statute.

The full text of the statutes governing Court-selection of health care coverage is at http://www.leg.state.mn.us/leg/statutes.asp -- select retrieve a section – type in 518A.41 (for Minn. Stat. Sec. 518A.41).