Look at any California child support order and chances are you will see health insurance cost has factored into the guideline child support number. Although it is common knowledge that health insurance is a factor in California child support orders, what many people don’t understand is how or why it is a factor. Here, we will explain how California family courts consider either parent’s health insurance coverage when determining the California child support order.
Any time a parent has health insurance coverage, the family court will order that parent to maintain the insurance coverage so long as that coverage is available for the supported child at no cost or a reasonable cost. Health insurance includes dental care and vision. The cost of maintaining the health insurance, typically an out-of-pocket cost that is deducted from the gross pay but not always taxed, is in ordered in addition to the California child support number.
In other words, the health insurance coverage order and maintaining it has the same force and effect as the California child support order and if a parent cancels his or her child’s health insurance when that health insurance was available to that parent at no cost or reasonable cost, that parent can be held in contempt of the court order.
Fortunately, for parents who do spend money out-of-pocket or through their paycheck to obtain health insurance coverage, the California Family Code does provide an allowance when calculating the California child support order. That means the cost to the parent for the health insurance is input as a factor in dissomaster or x-spouse (the most commonly used programs to determine California child support) and reduces the amount of child support.
What happens if health insurance is not available for either parent? Does that mean the child goes without insurance forever? No. The Court makes its standard orders in just about every child support case that requires each parent to obtain health insurance when it becomes available. Because this is a court order, a parent who has health insurance available to obtain for the child and does not do so can be held in violation of the court order.
What is reasonable? Does it simply depend on a case to case basis as to whether or not the cost of health insurance is reasonable to a parent or not? Because that would invite disputes, California has guidelines that have been established as to the definition of “reasonable.” As a general rule, the cost of health insurance is considered reasonable if it does not exceed 5% of the parent’s gross income. This 5% is the difference in cost between the health insurance cost for that parent only versus coverage for the children – what is sometimes called “family coverage”.
The cost of health insurance and the out-of-pocket premium to the parent in a California child support order must be distinguished from the issue of out-of-pocket uninsured medical costs. Though this can sometimes cause confusion, a parent generally does not have a reimbursement right against the other parent for the cost of health insurance.
However, if that parent incurred uninsured medical costs for a child (meaning the health insurance did not cover all of the medical costs and a parent had to pay money out-of-pocket), the paying parent has a right to recover 50% of that cost against the other parent as part of the child support order. This will be the subject of a future family law article where we will discuss how to obtain reimbursement of uninsured medical costs from the other parent and some traps that parents must be careful not fall into when requesting reimbursement or being asked for reimbursement.
Do you have a California child support order with which you need help? Are you confused as to why a court made a particular order or do you need assistance because you have a child support hearing coming up? Contact the experienced child support attorneys at our firm for a consultation.