Effective: June 1, 2012

Previous Policy

Out of State Coverage

If a parent who lives or works in another state has enrolled a child in his or her insurance plan coverage but the plan does not provide coverage or provides only limited coverage in Utah, the child may be enrolled in CHIP.

For example, the parent lives in Arizona and the child can only receive medical services in Arizona, or the insurance only covers emergency room visits in Utah, the child may be enrolled in CHIP.

However, if the plan provides coverage in Utah (does not have to be as comprehensive as CHIP covered services), the child is not eligible to enroll.

ORS Medical Support Enforcement

When a non-custodial parent has been court ordered to provide medical insurance coverage for a child, but has not enrolled the child in a health insurance plan, the child may be eligible for CHIP enrollment.

Tell the applicant about the medical support services available through ORS (Office of Recovery Services). If the applicant would like ORS assistance, give them a non public assistance packet and the address of the local ORS office where they can apply for services.

ORS will not automatically notify you if they are able to enforce the medical support order, so tell the applicant that he must report within 10 days if the child becomes enrolled in a health insurance plan.

Close the case with proper notice if you receive information that the child has been enrolled in a health insurance plan.

ORS may force enrollment in insurance under a National Medical Support Notice (NMSN) for the non-custodial and/or custodial parent. If the cost of insurance premium exceeds 5% of the gross monthly income of the obligated parent, the obligated parent may contest the NMSN based on a mistake of fact. If a parent successfully contests the action to enroll the children in the parent's insurance, ORS will notify the employer to discontinue enrollment and withholding of insurance premiums for the children. The child is then terminated from the insurance and the child is NOT subject to the 90 day sanction. (See 220-8 #2).