Federal law requires that the Child Support Enforcment Agency (CSEA) must petition the court or administrative authority to include private health insurance that is accessible to the child(ren), as defined by the State, and is available to the parent responsible for providing medical support at a reasonable cost, in new or modified court or administrative orders for support.  45 Code of Federal Regulations (C.F.R.) § 303.31(b)(1).  The cost is reasonable if the cost of adding the child(ren) to the existing coverage or the difference between self-only and family coverage is not more than five percent of the parent's gross income, or an alternative standard the State may adopt.  45 C.F.R. 303.31(a)(3). 

The Department of Human Services automatically refers all cases where a child receives Medicaid/Med-QUEST health insurance benefits to the CSEA to establish a medical support order requiring the noncustodial parent to provide private medical insurance coverage for the child.

The proposed administrative order may require that the noncustodial/responsible parent and/or the custodial parent provide health insurance (or cash medical support) for the child(ren) and submit written proof of coverage and a medical identification card to the CSEA.

Issues that may be addressed at a hearing regarding medical insurance coverage include:

• Whether the child is enrolled in Medicaid/Med-QUEST (public health insurance benefits)
• Which party is obligated by the current child support order to provide medical insurance coverage for the child
• the cost of adding the child(ren) to the existing coverage or the difference between self-only and family coverage
• whether health insurance is available at a reasonable cost

The Hearings Officer will determine whether evidence presented at the hearing is relevant to the proceeding.  Even if the custodial parent is obligated by the applicable child support order to provide medical insurance coverage, if he or she subsequently enrolls the child in Medicaid/Medquest public health insurance, at the hearing the order will usually be changed to require the responsible parent to provide private medical insurance for the child instead.

To prepare for a hearing the party should read thoroughly all documents he or she receives from the CSEA and the OCSH.  These documents will explain the action the CSEA is proposing and what laws and/or regulations govern it.  See also the Preparing for Your Hearing section of this website. 

Documents parties may want to present at the administrative hearing are: 

• prior court or administrative orders
• evidence regarding the availability of health insurance for the child to the responsible parent at reasonable cost
• evidence regarding the cost of adding the child(ren) to the existing coverage or the difference between self-only and family coverage
• relevant correspondence, letters, or documents received from the CSEA
• any other relevant information

Parties should submit documents they intend to present at the hearing to the CSEA at least one week prior to the hearing.  These documents may be delivered or mailed to: CSEA, Attention:  APB Hearing Coordinator, 601 Kamokila Blvd., Suite 251, Kapolei, Hawai‘i, 96707.