Senate Bill S4214

Signed By Governor

2009-2010 Legislative Session

Establishes definitions for "cash medical support", "reasonable in cost" and "reasonably accessible"; repealer

download bill text pdf

Archive: Last Bill Status Via A8977 - Signed by Governor

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jul 11, 2009	signed chap.215
Jul 10, 2009	delivered to governor
Jul 09, 2009	returned to assembly repassed senate vote reconsidered - restored to third reading
Jun 30, 2009	passed senate 3rd reading cal.665 substituted for s4214b
Jun 30, 2009	substituted by a8977 ordered to third reading cal.665 committee discharged and committed to rules
Jun 19, 2009	print number 4214b
Jun 19, 2009	amend and recommit to finance print number 4214a
Jun 19, 2009	amend and recommit to finance
May 19, 2009	reported and committed to finance
Apr 17, 2009	referred to judiciary

Votes

- Jul 9, 2009 - Floor Vote
  A8977
  
  Aye
  
  62
  
  Nay
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  
  0
  - - Floor Vote: Jul 9, 2009
      
      aye (62)
      
      Adams
      
      Addabbo Jr.
      
      Alesi
      
      Aubertine
      
      Bonacic
      
      Breslin
      
      DeFrancisco
      
      Diaz
      
      Dilan
      
      Duane
      
      Espada
      
      Farley
      
      Flanagan
      
      Foley
      
      Fuschillo
      
      Golden
      
      Griffo
      
      Hannon
      
      Hassell-Thompson
      
      Huntley
      
      Johnson
      
      Johnson
      
      Klein
      
      Krueger
      
      Kruger
      
      LaValle
      
      Lanza
      
      Larkin
      
      Leibell
      
      Libous
      
      Little
      
      Marcellino
      
      Maziarz
      
      McDonald
      
      Monserrate
      
      Montgomery
      
      Morahan
      
      Nozzolio
      
      Onorato
      
      Oppenheimer
      
      Padavan
      
      Parker
      
      Perkins
      
      Ranzenhofer
      
      Robach
      
      Saland
      
      Sampson
      
      Savino
      
      Schneiderman
      
      Serrano
      
      Seward
      
      Skelos
      
      Smith
      
      Squadron
      
      Stachowski
      
      Stavisky
      
      Stewart-Cousins
      
      Thompson
      
      Valesky
      
      Volker
      
      Winner
      
      Young
  Jun 30, 2009 - Rules Committee Vote
  S4214
  
  Aye
  
  13
  
  Nay
  
  0
  
  Aye with Reservations
  
  0
  
  Absent
  
  11
  
  Excused
  
  0
  
  Abstained
  
  0
  - - Rules Committee Vote: Jun 30, 2009
      
      aye (13)
      
      Dilan
      
      Duane
      
      Hassell-Thompson
      
      Klein
      
      Krueger
      
      Monserrate
      
      Montgomery
      
      Parker
      
      Serrano
      
      Smith
      
      Stachowski
      
      Stewart-Cousins
      
      Valesky
      
      absent (11)
      
      Espada
      
      Farley
      
      Hannon
      
      Johnson
      
      LaValle
      
      Larkin
      
      Padavan
      
      Saland
      
      Seward
      
      Skelos
      
      Volker

Bill Amendments

Original

B (Active)

2009-S4214 - Details

Law Section:: Family Court Act
Laws Affected:: Rpld & add §413 sub 1 ¶(c) sub¶ 5, §416 sub (f), amd §§416, 514 & 545, Fam Ct Act; rpld & add §240 sub 1-b ¶(c) sub¶ 5, sub 1 ¶(d), amd §240, Dom Rel L; amd §5241, CPLR

2009-S4214 - Summary

Establishes definitions for "cash medical support", "reasonable in cost" and "reasonably accessible"; amends the priority for deductions via an income execution.

2009-S4214 - Sponsor Memo

                                 BILL NUMBER:  S4214

 TITLE OF BILL :

An act to amend the family court act and the domestic relations law,
in relation to establishing definitions for "cash medical support",
and when health insurance benefits are "reasonable in cost" and
"reasonably accessible"; to amend the civil practice law and rules, in
relation to amending the priority for deductions via an income
execution; and to repeal certain provisions of the family court act
and the domestic relations law relating thereto


 PURPOSE OF THE BILL :

This bill would enact federal mandates set forth in the final medical
support regulations for the child support enforcement program,
released by the federal Department of Health and Human Services on
July 21, 2008. The federal regulations require each state to define
when private health insurance benefits, an element of support, are
"reasonable in cost" and when such health insurance shall be
considered "reasonably accessible."

 SUMMARY OF PROVISIONS :

Sections 1 and 2 of the bill would amend section 413 of the Family

Court Act (FCA) and section 240 of the Domestic Relations Law (DRL),
respectively, to define the term "cash medical support" and provide an
income-based numeric standard for determining when cash medical
support should be· ordered and the amount of each parent's
contribution. For children enrolled in State Child Health Insurance
Program (SCHIP), the portion of cash medical support attributable to
public coverage is the pro rata share of the family contribution under
the state's child health insurance plan. For children enrolled in the
Medical Assistance (MA) program, the non-custodial parent's obligation
for the portion of cash medical support attributable to public
benefits is the lesser of (1) the amount that would be required under
SCHIP using the combined income of the parents as if the child(ren)
were in a two-parent household; or, (2) the actual amount expended by
the MA program. For children enrolled in either program, the total
cash medical support obligation (including costs attributable to
public coverage or benefits and unreimbursed health care costs) shall
not exceed 5% of the non-custodial parent's income or reduce the
parent's income below the self-support reserve.

Sections 3 and 4 of the bill would amend section 416 of the FCA and
section 240 of the DRL, respectively, to define the terms "reasonable
in cost" and "reasonably accessible," to aid the court in determining
whether private health insurance benefits are available to a child.

Sections 5 and 6 of the bill would amend section 416(e)(2)(iii) of the
FCA and section 240(1)(c)(2)(iii) of the DRL These sections provide
that when private health insurance coverage is unavailable, the child
must be directed to apply for SCHIP or MA.  The current language
allowing the court to apportion the cost of any premium, family
contribution, or health expense associated with participation in such
plan or program is deleted.

Sections 7 and 8 of the bill, as noted above, would amend section
416(f) of the FCA and section 240(l)(d) of the DRL These sections
currently provide for the proration of costs between the parties where
private health insurance is ordered. The subdivisions are amended to
state that the cost of private health insurance, or the cost of any
premium, family contribution, or health expense incurred as a result
of enrollment in SCHIP or the MA program shall be deemed cash medical

support and each parent's contribution will be determined under the
amended provisions in sections 1 and 2 of this bill.

Sections 9 and 10 of the bill would amend sections 514 and 545 of the
FCA, respectively, to provide that the necessary expenses incurred by
or for the mother in connection with her pregnancy, confinement and
recovery shall be deemed a cash medical support obligation to the
father.

Section 11 of the bill would amend section 5241 (b)(2)(i) of the Civil
Practice Law and Rules (CPLR) to correct a statutory reference.

Section 12 of the bill would amend section 5241(h) of the CPLR to
revise the priority of deductions made by an employer or income payor
in response to an income execution, medical support execution or
income deduction order. Under this bill, the employer will first
deduct the amount due for current child support obligations, then the
cost of health insurance premiums, then the additional amount to
reduce child support arrears.

Section 13 of the bill would provide that the amendments will be
effective on the ninetieth day after the bill becomes law and apply to
any proceeding to establish or modify a child support obligation,
including a medical support obligation, commenced after that date.

 EXISTING LAW :

Various sections of the FCA, the DRL and the Social Services Law (SSL)
contain provisions concerning the obligation of parents to support
their children and provide procedures for the establishment of
paternity and the establishment, enforcement and modification of child
support obligations, including the cost of health insurance coverage
and other health care expenses. Section 5241 of the CPLR contains the
procedure associated with utilizing income executions and medical
support executions for support enforcement.

 PRIOR LEGISLATIVE HISTORY :

In the 2008 Legislative Session, provisions similar to sections three
and four of this bill were part of S.8340, but S.8340 was not reported
from the Senate Rules Committee.

 STATEMENT IN SUPPORT :

The provision of health insurance benefits and medical support is an
important component of child support. This bill would allow New York
to comply with the federal final rule (45 CFR 302.56; 303.31)
pertaining to medical support, which requires states to define the
terms "reasonable in cost" and "reasonably accessible" in relation to
the availability of private health insurance, and also the federal
mandate to set a reasonable income-based numeric standard for
determining when cash medical support should be ordered.

Under federal, regulations, private health insurance is considered
"available" when it is reasonable in cost and reasonably accessible as
those terms are defined by a state. In the event that private health
insurance is not "available," the regulations mandate that states seek
an order for "cash medical support" until such time as private health
insurance becomes available. Additionally, the final medical support
regulations. allow states to define when it is appropriate to seek
cash medical support in addition to private health Insurance coverage.

This bill would define "cash medical support" under the child support
standards as the amount to be paid for the cost of health insurance
provided by a public entity or by a parent through employment or
otherwise, and/or for other health care costs not covered by
insurance. It sets out the method of apportioning the cost of the
different types of cash medical support, such as private health
insurance premiums, benefits provided by the SCHIP . and the MA
program, as well as health care expenses not covered by health
insurance. The bill also limits the establishment of cash medical
support obligations in support orders so that the non-custodial
parent's income will not be reduced below the self-support reserve
(135% of the federal poverty income guidelines for a single person).

This bill would adopt the federal definition of cash medical support
and provide a method for the court to determine the parties'
obligation to provide each of the three types of cash medical support.
First, if private health insurance benefits are determined by a court
to be "available" (i.e., 5% or less of the parties' gross income), the
court must order the non-custodial parent to pay his or her pro rata
share of the health insurance premium. The primary goal of these
provisions is to ensure that private health insurance is utilized when
available at reasonable cost. The use of private health insurance may
reduce the costs of health care for the child expended by the parents
and the public.

Second, if the child covered by private health insurance incurs
additional unreimbursed health care expenses, the court shall order
the non-custodial parent to pay his or her pro rata share of the
reasonable cash medical support expenses. Orders requiring the
non-custodial parent to pay his or her share of unreimbursed health
care expenses are currently a mandatory provision under the Child
Support Standards Act. The bill continues this obligation, but sets
forth a cap on periodic payment schedules and limits on the amount
ordered to be paid by individuals with private health insurance.  When
combined with the cost to the parent for private health insurance, the
total payment ordered by the court for cash medical support may not
exceed 20% of the non-custodial parent's gross income or cause his or
her income to fall below the self-support reserve.

Third, where private health insurance benefits are determined by the
court not to be "available," the custodial parent will be ordered, in
accordance with current law, to apply for SCHIP or MA. If the child is
determined eligible for SCHIP, the portion of cash medical support
associated with public coverage or benefits is the prorated share of
the family contribution under SCHIP. For children enrolled in MA
(regardless of whether it is managed care or fee-for-service), the
non-custodial parent's obligation towards the portion of cash medical
support for public coverage or benefits is the lesser of the amount
that would be required under SCHIP using the combined income of the
parents as if the child(ren) were in a two-parent household, or the
actual amount expended by the MA program. In managed care cases, the
court will order a monthly obligation for the portion of cash medical
support associated with public coverage. In fee-for-service cases, for
the portion of cash medical support associated with public coverage,
the court will order a maximum annual cash support obligation based on
the amount that would be required under SCHIP.  For children enrolled
in either program, in no case shall the total cash medical support
obligation (including the obligation for public coverage or benefits,
plus unreimbursed health care expenses) exceed 5% of the non-custodial
parent's gross income, or the difference between the non-custodial
parent's income and the self-support reserve, whichever is less.

The bill would also define two terms that are considered by courts in
determining whether private health insurance benefits are available to
a child. Private health insurance benefits must be "reasonable in
cost" and "reasonably accessible" in order to be deemed available.

The first term, "reasonable in cost," is defined in this bill to mean
that the cost of private health insurance does not exceed five percent
of the combined parental gross income. However, no benefits will be
considered "reasonable in cost" if the' cost to a parent of extending
coverage to the child(ren) would reduce the income of that parent
below the self-support reserve. In addition, upon a finding of the
court that the cost borne by a parent is unjust or inappropriate, the
presumption of cost-reasonableness may be rebutted. Pursuant to the
federal regulations, where the child(ren) will be added to existing
benefits, the "cost" to be considered in determining reasonableness is
the cost of adding the child who is the subject of the order. However,
where there is no existing coverage, the "cost" to be considered in
determining reasonableness is the difference between self-only
(individual) benefits and health insurance benefits which extend to
a11 the children who are the subject of the order.

"Reasonably accessible" is defined to mean that the child lives within
the geographic area covered by the plan or lives within forty-five
miles of services covered by the health insurance benefits or through
benefits provided under a reciprocal agreement. The presumption of
accessibility may be rebutted for good. cause shown which may include,
but is not limited to, a consideration of the special health needs of
the subject child.

In addition to complying with the federal mandate, these provisions
will improve child support orders. Currently, the courts do not have a
standard definition of reasonable cost. Different courts apply
different standards, and even calculate the cost of health insurance
differently. Greater consistency in determining whether health
insurance is available - that is, reasonable in cost and reasonably
accessible - is anticipated as a result of this bill. In addition, the
court is given flexibility to address the parties' individual
circumstances and set an order that is just and appropriate.

The bill would also clarify that the cost of private health insurance
premiums or any premium, family contribution, or health expense
associated with enrollment of a child in SCHIP or MA is cash medical
support. The proposed amendments refer the court to the Child Support
Standards Act to calculate the amount of each parties' contribution to
the cost of these expenses.

The bill would further clarify that the necessary expenses incurred by
or for the mother in connection with her pregnancy, confinement and
recovery are a cash medical support obligation to the father. Where
these expenses were paid under the MA program on the mother's behalf,
the father's liability to the social services district and the State
will be subject to the same cap and low income protections as cash
medical support for other MA expenses.

Finally, the bill amends the priorities for income withholding by an
employer or other income payor. Consistent with the goal of providing
private health insurance coverage whenever possible, deductions to
satisfy support obligations will have the following priority: (1)
current support obligations; (2) health insurance premiums; and (3)
arrears.

 BUDGET IMPLICATIONS :

Failure to pass this bill will put the State out of IV-D Plan
compliance and subject the State to elimination of federal
reimbursement.

 EFFECTIVE DATE :
The bill would take effect on the ninetieth day after it becomes a law
and apply to any proceeding to establish or modify a child support
obligation, including a medical support obligation, commenced after
that date.

2009-S4214 - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4214

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             April 17, 2009
                               ___________

Introduced by Sen. SAMPSON -- (at request of the Office of Temporary and
  Disability  Assistance)  --  read  twice and ordered printed, and when
  printed to be committed to the Committee on Judiciary

AN ACT to amend the family court act and the domestic relations law,  in
  relation  to  establishing definitions for "cash medical support", and
  when health insurance benefits are "reasonable in cost"  and  "reason-
  ably  accessible";  to  amend  the  civil  practice  law and rules, in
  relation to  amending  the  priority  for  deductions  via  an  income
  execution;  and  to  repeal certain provisions of the family court act
  and the domestic relations law relating thereto

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subparagraph 5 of paragraph (c) of subdivision 1 of section
413  of  the  family  court  act is REPEALED and a new subparagraph 5 is
added to read as follows:
  (5) THE COURT SHALL  DETERMINE  THE  PARTIES'  OBLIGATION  TO  PROVIDE
HEALTH  INSURANCE  BENEFITS  PURSUANT TO SECTION FOUR HUNDRED SIXTEEN OF
THIS PART AND TO PAY CASH MEDICAL SUPPORT AS PROVIDED UNDER THIS SUBPAR-
AGRAPH.
  (I) "CASH MEDICAL SUPPORT" MEANS AN AMOUNT ORDERED TO BE  PAID  TOWARD
THE  COST OF HEALTH INSURANCE PROVIDED BY A PUBLIC ENTITY OR BY A PARENT
THROUGH EMPLOYMENT OR OTHERWISE, AND/OR FOR OTHER HEALTH  CARE  EXPENSES
NOT COVERED BY INSURANCE.
  (II)  WHERE  HEALTH  INSURANCE  BENEFITS PURSUANT TO PARAGRAPH ONE AND
SUBPARAGRAPHS (I) AND (II)  OF  PARAGRAPH  TWO  OF  SUBDIVISION  (E)  OF
SECTION FOUR HUNDRED SIXTEEN OF THIS PART ARE DETERMINED BY THE COURT TO
BE  AVAILABLE,  THE COST OF PROVIDING HEALTH INSURANCE BENEFITS SHALL BE
PRORATED BETWEEN THE PARTIES IN THE SAME  PROPORTION  AS  EACH  PARENT'S
INCOME  IS  TO  THE COMBINED PARENTAL INCOME. IF THE CUSTODIAL PARENT IS
ORDERED TO PROVIDE SUCH BENEFITS, THE NON-CUSTODIAL  PARENT'S  PRO  RATA
SHARE  OF  SUCH COSTS SHALL BE ADDED TO THE BASIC SUPPORT OBLIGATION. IF

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07704-03-9

S. 4214                             2

THE NON-CUSTODIAL PARENT IS ORDERED TO PROVIDE SUCH BENEFITS, THE CUSTO-
DIAL PARENT'S PRO RATA SHARE OF SUCH COSTS SHALL BE  DEDUCTED  FROM  THE
BASIC  SUPPORT  OBLIGATION.    IN ADDITION, THE COURT SHALL PRORATE EACH
PARENT'S  SHARE  OF OTHER HEALTH CARE EXPENSES NOT COVERED BY INSURANCE,
IN THE SAME PROPORTION AS  EACH  PARENT'S  INCOME  IS  TO  THE  COMBINED
PARENTAL  INCOME,  AND  STATE  THE  NON-CUSTODIAL  PARENT'S  SHARE  AS A
PERCENTAGE IN THE ORDER. UPON PROOF TO  THE  COURT  THAT  THE  CUSTODIAL
PARENT HAS INCURRED HEALTH CARE EXPENSES, THE COURT SHALL DETERMINE EACH
PARENT'S  SHARE THEREOF AND ORDER THE NON-CUSTODIAL PARENT TO PAY HIS OR
HER SHARE, REGARDLESS OF WHETHER THE CUSTODIAL PARENT HAS ACTUALLY  PAID
THE  EXPENSE  AT THE TIME OF THE DETERMINATION. THE TOTAL AMOUNT OF CASH
MEDICAL SUPPORT DETERMINED BY THE COURT  TO  BE  DUE  SHALL  BE  SUPPORT
ARREARS/PAST  DUE  SUPPORT  AND  SHALL  BE  SUBJECT  TO  ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
IN ADDITION, THE NON-CUSTODIAL PARENT'S PRO  RATA  SHARE  OF  SUCH  CASH
MEDICAL  SUPPORT  SHALL  BE  PAID IN ONE SUM OR IN PERIODIC SUMS, AS THE
COURT DIRECTS, INCLUDING DIRECT PAYMENT TO  THE  HEALTH  CARE  PROVIDER;
PROVIDED,  HOWEVER, THAT IF THE NON-CUSTODIAL PARENT IS DIRECTED TO MAKE
PERIODIC PAYMENTS, THE TOTAL OF ALL PERIODIC PAYMENTS UNDER THIS  CLAUSE
SHALL  NOT EXCEED TWENTY PERCENT OF THE PARENT'S GROSS INCOME. THE COURT
SHALL NOT ORDER A PAYMENT THAT WOULD REDUCE THE  NON-CUSTODIAL  PARENT'S
INCOME BELOW THE SELF-SUPPORT RESERVE.
  (III)  WHERE  HEALTH  INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPHS (I)
AND (II) OF PARAGRAPH TWO OF SUBDIVISION (E)  OF  SECTION  FOUR  HUNDRED
SIXTEEN  OF  THIS PART ARE DETERMINED BY THE COURT TO BE UNAVAILABLE, IF
THE CHILD IS DETERMINED ELIGIBLE FOR COVERAGE UNDER THE MEDICAL  ASSIST-
ANCE PROGRAM ESTABLISHED PURSUANT TO TITLE ELEVEN OF ARTICLE FIVE OF THE
SOCIAL  SERVICES  LAW, THE COURT SHALL ORDER THE NON-CUSTODIAL PARENT TO
PAY AN AMOUNT FOR SUCH CHILD EQUAL TO THE LESSER OF: (A) THE AMOUNT THAT
WOULD BE REQUIRED AS A  FAMILY  CONTRIBUTION  UNDER  THE  STATE'S  CHILD
HEALTH  INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF
THE PUBLIC HEALTH LAW FOR THE CHILD, IF HE OR SHE WERE IN  A  TWO-PARENT
HOUSEHOLD  WITH INCOME EQUAL TO THE COMBINED INCOME OF THE NON-CUSTODIAL
AND CUSTODIAL PARENTS; OR (B) THE ACTUAL AMOUNT EXPENDED BY THE  MEDICAL
ASSISTANCE PROGRAM ON BEHALF OF THE CHILD OR CHILDREN.  IN THE CASE OF A
CHILD  AUTHORIZED FOR MANAGED CARE COVERAGE UNDER THE MEDICAL ASSISTANCE
PROGRAM, THE COURT SHALL SEPARATELY STATE THE MONTHLY OBLIGATION. IN THE
CASE OF A  CHILD  AUTHORIZED  FOR  FEE-FOR-SERVICE  COVERAGE  UNDER  THE
MEDICAL ASSISTANCE PROGRAM, THE COURT SHALL DETERMINE THE MAXIMUM ANNUAL
CASH  SUPPORT OBLIGATION UNDER SUBCLAUSE (A) OF THIS CLAUSE, WHICH SHALL
BE EQUAL TO TWELVE TIMES THE MONTHLY CONTRIBUTION CALCULATED UNDER  SUCH
SUBCLAUSE  OR  SUCH PORTION OF THE YEAR THAT THE CHILD IS AUTHORIZED FOR
FEE-FOR-SERVICE COVERAGE, AND SHALL ORDER THE  NON-CUSTODIAL  PARENT  TO
PAY  UP  TO THE MAXIMUM ANNUAL CASH SUPPORT OBLIGATION UPON PROOF TO THE
COURT THAT THE PUBLIC ENTITY HAS  INCURRED  HEALTH  CARE  EXPENSES.  THE
COURT  MAY ORDER THE MONTHLY CONTRIBUTION CALCULATED UNDER SUBCLAUSE (A)
OF THIS CLAUSE TO BE PAID BY THE NON-CUSTODIAL PARENT FOR  MONTHS  PRIOR
TO  THE  ISSUANCE  OF THE COURT'S ORDER, UPON A SHOWING THAT THE MEDICAL
ASSISTANCE PROGRAM INCURRED HEALTH CARE  EXPENSES  DURING  SUCH  MONTHS,
REGARDLESS  OF  WHETHER THE MEDICAL ASSISTANCE PROGRAM HAS ACTUALLY PAID
THE EXPENSES AT THE TIME OF THE ORDER; SUCH  AMOUNTS  SHALL  BE  SUPPORT
ARREARS/PAST  DUE  SUPPORT  AND  SHALL  BE  SUBJECT  TO  ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
IN ADDITION, THE COURT SHALL PRORATE EACH PARENT'S SHARE OF OTHER HEALTH
CARE EXPENSES NOT COVERED BY THE MEDICAL ASSISTANCE PROGRAM, IN THE SAME
PROPORTION AS EACH PARENT'S INCOME IS TO THE COMBINED  PARENTAL  INCOME,

S. 4214                             3

AND STATE THE NON-CUSTODIAL PARENT'S SHARE AS A PERCENTAGE IN THE ORDER.
IN THE CASE OF A CHILD AUTHORIZED FOR FEE-FOR-SERVICE COVERAGE UNDER THE
MEDICAL ASSISTANCE PROGRAM, THE COURT SHALL DETERMINE THE MAXIMUM ANNUAL
CASH  SUPPORT OBLIGATION UNDER SUBCLAUSE (A) OF THIS CLAUSE, WHICH SHALL
BE EQUAL TO TWELVE TIMES THE MONTHLY CONTRIBUTION CALCULATED UNDER  SUCH
SUBCLAUSE.    THE  TOTAL  ANNUAL AMOUNT OF CASH MEDICAL SUPPORT THAT THE
NON-CUSTODIAL PARENT IS ORDERED TO  PAY  UNDER  THIS  CLAUSE  SHALL  NOT
EXCEED  FIVE  PERCENT  OF  HIS  OR  HER  GROSS INCOME, OR THE DIFFERENCE
BETWEEN THE NON-CUSTODIAL PARENT'S INCOME AND THE SELF-SUPPORT  RESERVE,
WHICHEVER IS LESS.
  (IV) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPHS (I) AND
(II) OF PARAGRAPH TWO OF SUBDIVISION (E) OF SECTION FOUR HUNDRED SIXTEEN
OF  THIS  PART  ARE  DETERMINED  BY THE COURT TO BE UNAVAILABLE, AND THE
CHILD IS DETERMINED ELIGIBLE FOR COVERAGE UNDER THE STATE'S CHILD HEALTH
INSURANCE PLAN PURSUANT TO TITLE ONE-A OF  ARTICLE  TWENTY-FIVE  OF  THE
PUBLIC  HEALTH  LAW,  THE COURT SHALL PRORATE EACH PARENT'S SHARE OF THE
COST OF THE FAMILY CONTRIBUTION REQUIRED UNDER SUCH CHILD HEALTH  INSUR-
ANCE  PLAN  IN  THE  SAME  PROPORTION  AS EACH PARENT'S INCOME IS TO THE
COMBINED PARENTAL INCOME, AND STATE  THE  AMOUNT  OF  THE  NON-CUSTODIAL
PARENT'S  SHARE  IN  THE  ORDER.   THE COURT MAY ORDER THE NON-CUSTODIAL
PARENT TO PAY HIS OR HER SHARE OF THE  FAMILY  CONTRIBUTION  FOR  MONTHS
PRIOR  TO  THE  ISSUANCE  OF  THE COURT'S ORDER, UPON A SHOWING THAT THE
CHILD WAS ENROLLED IN  THE  CHILD  HEALTH  INSURANCE  PLAN  DURING  SUCH
MONTHS,  AND  SUCH  SHARE  SHALL BE SUPPORT ARREARS/PAST DUE SUPPORT AND
SHALL BE SUBJECT TO ANY REMEDIES AS PROVIDED BY LAW FOR THE  ENFORCEMENT
OF  SUPPORT  ARREARS/PAST  DUE  SUPPORT.    IN ADDITION, THE COURT SHALL
PRORATE EACH PARENT'S SHARE OF OTHER HEALTH CARE EXPENSES NOT COVERED BY
THE CHILD HEALTH INSURANCE PLAN, IN THE SAME PROPORTION AS EACH PARENT'S
INCOME IS TO THE COMBINED PARENTAL INCOME, AND STATE  THE  NON-CUSTODIAL
PARENT'S  SHARE  AS A PERCENTAGE IN THE ORDER.  THE TOTAL AMOUNT OF CASH
MEDICAL SUPPORT THAT THE NON-CUSTODIAL PARENT IS ORDERED  TO  PAY  UNDER
THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER GROSS INCOME, OR
THE  DIFFERENCE  BETWEEN  THE  NON-CUSTODIAL  PARENT'S  INCOME  AND  THE
SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (V) UPON PROOF BY EITHER PARTY THAT CASH MEDICAL SUPPORT  PURSUANT  TO
CLAUSES  (II),  (III)  OR  (IV)  OF THIS SUBPARAGRAPH WOULD BE UNJUST OR
INAPPROPRIATE PURSUANT TO PARAGRAPH  (F)  OF  SUBDIVISION  ONE  OF  THIS
SECTION, THE COURT SHALL:
  (A)  ORDER  THE PARTIES TO PAY CASH MEDICAL SUPPORT AS THE COURT FINDS
JUST AND APPROPRIATE, CONSIDERING THE BEST INTERESTS OF THE CHILD; AND
  (B) SET FORTH IN THE ORDER THE FACTORS IT CONSIDERED,  THE  AMOUNT  OF
EACH  PARTY'S SHARE OF THE COST, THE REASON OR REASONS THE COURT DID NOT
ORDER SUCH PRO RATA APPORTIONMENT, AND THE BASIS FOR THE AMOUNT AWARDED.
  S 2. Subparagraph 5 of paragraph (c) of subdivision 1-b of section 240
of the domestic relations law is REPEALED and a new  subparagraph  5  is
added to read as follows:
  (5)  THE  COURT  SHALL  DETERMINE  THE  PARTIES' OBLIGATION TO PROVIDE
HEALTH INSURANCE BENEFITS PURSUANT TO  THIS  SECTION  AND  TO  PAY  CASH
MEDICAL SUPPORT AS PROVIDED UNDER THIS SUBPARAGRAPH.
  (A)  "CASH  MEDICAL SUPPORT" MEANS AN AMOUNT ORDERED TO BE PAID TOWARD
THE COST OF HEALTH INSURANCE PROVIDED BY A PUBLIC ENTITY OR BY A  PARENT
THROUGH  EMPLOYMENT  OR OTHERWISE, AND/OR FOR OTHER HEALTH CARE EXPENSES
NOT COVERED BY INSURANCE.
  (B) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPH  ONE  AND
CLAUSES (I) AND (II) OF SUBPARAGRAPH TWO OF PARAGRAPH (C) OF SUBDIVISION
ONE  OF  THIS  SECTION  ARE DETERMINED BY THE COURT TO BE AVAILABLE, THE

S. 4214                             4

COST OF PROVIDING HEALTH INSURANCE BENEFITS SHALL  BE  PRORATED  BETWEEN
THE  PARTIES  IN  THE  SAME PROPORTION AS EACH PARENT'S INCOME IS TO THE
COMBINED PARENTAL INCOME. IF THE CUSTODIAL PARENT IS ORDERED TO  PROVIDE
SUCH  BENEFITS,  THE NON-CUSTODIAL PARENT'S PRO RATA SHARE OF SUCH COSTS
SHALL BE ADDED TO THE BASIC SUPPORT  OBLIGATION.  IF  THE  NON-CUSTODIAL
PARENT  IS  ORDERED TO PROVIDE SUCH BENEFITS, THE CUSTODIAL PARENT'S PRO
RATA SHARE OF SUCH COSTS SHALL BE DEDUCTED FROM THE BASIC SUPPORT  OBLI-
GATION.  IN ADDITION, THE COURT SHALL PRORATE EACH PARENT'S SHARE OF ALL
OTHER  CASH  MEDICAL  SUPPORT,  INCLUDING OTHER HEALTH CARE EXPENSES NOT
COVERED BY INSURANCE, IN THE SAME PROPORTION AS EACH PARENT'S INCOME  IS
TO  THE  COMBINED  PARENTAL INCOME, AND STATE THE NON-CUSTODIAL PARENT'S
SHARE AS A PERCENTAGE IN THE ORDER. UPON PROOF TO  THE  COURT  THAT  THE
CUSTODIAL  PARENT  HAS  INCURRED  HEALTH  CARE EXPENSES, THE COURT SHALL
DETERMINE EACH PARENT'S SHARE THEREOF AND ORDER THE NON-CUSTODIAL PARENT
TO PAY HIS OR HER SHARE, REGARDLESS OF WHETHER THE CUSTODIAL PARENT  HAS
ACTUALLY  PAID  THE EXPENSE AT THE TIME OF THE DETERMINATION.  THE TOTAL
AMOUNT OF CASH MEDICAL SUPPORT DETERMINED BY THE COURT TO BE  DUE  SHALL
BE SUPPORT ARREARS/PAST DUE SUPPORT AND SHALL BE SUBJECT TO ANY REMEDIES
AS  PROVIDED  BY  LAW  FOR  THE  ENFORCEMENT OF SUPPORT ARREARS/PAST DUE
SUPPORT. IN ADDITION, THE NON-CUSTODIAL PARENT'S PRO RATA SHARE OF  SUCH
CASH  MEDICAL  SUPPORT  SHALL BE PAID IN ONE SUM OR IN PERIODIC SUMS, AS
THE COURT DIRECTS, INCLUDING DIRECT PAYMENT TO THE HEALTH CARE PROVIDER;
PROVIDED, HOWEVER, THAT IF THE NON-CUSTODIAL PARENT IS DIRECTED TO  MAKE
PERIODIC  PAYMENTS, THE TOTAL OF ALL PERIODIC PAYMENTS UNDER THIS CLAUSE
SHALL NOT EXCEED TWENTY PERCENT OF THE PARENT'S GROSS INCOME. THE  COURT
SHALL  NOT  ORDER A PAYMENT THAT WOULD REDUCE THE NON-CUSTODIAL PARENT'S
INCOME BELOW THE SELF-SUPPORT RESERVE.
  (C) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPHS (I)  AND
(II) OF PARAGRAPH TWO OF SUBDIVISION (E) OF SECTION FOUR HUNDRED SIXTEEN
OF  THE  FAMILY COURT ACT ARE DETERMINED BY THE COURT TO BE UNAVAILABLE,
IF THE CHILD IS DETERMINED  ELIGIBLE  FOR  COVERAGE  UNDER  THE  MEDICAL
ASSISTANCE  PROGRAM ESTABLISHED PURSUANT TO TITLE ELEVEN OF ARTICLE FIVE
OF THE SOCIAL SERVICES LAW, THE  COURT  SHALL  ORDER  THE  NON-CUSTODIAL
PARENT  TO  PAY AN AMOUNT FOR SUCH CHILD EQUAL TO THE LESSER OF: (A) THE
AMOUNT THAT WOULD BE REQUIRED AS A FAMILY CONTRIBUTION UNDER THE STATE'S
CHILD  HEALTH  INSURANCE  PLAN  PURSUANT  TO  TITLE  ONE-A  OF   ARTICLE
TWENTY-FIVE  OF THE PUBLIC HEALTH LAW FOR THE CHILD IF HE OR SHE WERE IN
A TWO-PARENT HOUSEHOLD WITH INCOME EQUAL TO THE COMBINED INCOME  OF  THE
NON-CUSTODIAL  AND  CUSTODIAL PARENTS; OR (B) THE ACTUAL AMOUNT EXPENDED
BY THE MEDICAL ASSISTANCE PROGRAM ON BEHALF OF THE  CHILD  OR  CHILDREN.
IN  THE  CASE  OF A CHILD AUTHORIZED FOR MANAGED CARE COVERAGE UNDER THE
MEDICAL ASSISTANCE PROGRAM, THE COURT SHALL SEPARATELY STATE THE MONTHLY
OBLIGATION. IN THE CASE OF A CHILD AUTHORIZED FOR FEE-FOR-SERVICE COVER-
AGE UNDER THE MEDICAL ASSISTANCE PROGRAM, THE COURT SHALL DETERMINE  THE
MAXIMUM  ANNUAL  CASH  SUPPORT  OBLIGATION  UNDER  SUBCLAUSE (A) OF THIS
CLAUSE, WHICH SHALL BE EQUAL TO TWELVE TIMES  THE  MONTHLY  CONTRIBUTION
CALCULATED  UNDER  SUCH  SUBCLAUSE  OR SUCH PORTION OF THE YEAR THAT THE
CHILD IS AUTHORIZED FOR FEE-FOR-SERVICE COVERAGE, AND  SHALL  ORDER  THE
NON-CUSTODIAL  PARENT TO PAY UP TO THE MAXIMUM ANNUAL CASH SUPPORT OBLI-
GATION UPON PROOF TO THE COURT  THAT  THE  PUBLIC  ENTITY  HAS  INCURRED
HEALTH  CARE  EXPENSES.  THE  COURT  MAY  ORDER THE MONTHLY CONTRIBUTION
CALCULATED UNDER SUBCLAUSE (A) OF THIS CLAUSE TO BE PAID BY THE NON-CUS-
TODIAL PARENT FOR MONTHS PRIOR TO THE ISSUANCE  OF  THE  COURT'S  ORDER,
UPON  A SHOWING THAT THE MEDICAL ASSISTANCE PROGRAM INCURRED HEALTH CARE
EXPENSES DURING SUCH MONTHS, REGARDLESS OF WHETHER THE  MEDICAL  ASSIST-
ANCE  PROGRAM  HAS  ACTUALLY PAID THE EXPENSES AT THE TIME OF THE ORDER;

S. 4214                             5

SUCH AMOUNTS SHALL BE SUPPORT ARREARS/PAST  DUE  SUPPORT  AND  SHALL  BE
SUBJECT  TO  ANY  REMEDIES  AS  PROVIDED  BY  LAW FOR THE ENFORCEMENT OF
SUPPORT ARREARS/PAST DUE SUPPORT.  IN ADDITION, THE COURT SHALL  PRORATE
EACH  PARENT'S  SHARE  OF  OTHER HEALTH CARE EXPENSES NOT COVERED BY THE
MEDICAL ASSISTANCE PROGRAM, IN THE  SAME  PROPORTION  AS  EACH  PARENT'S
INCOME  IS  TO THE COMBINED PARENTAL INCOME, AND STATE THE NON-CUSTODIAL
PARENT'S SHARE AS A PERCENTAGE IN THE ORDER. IN  THE  CASE  OF  A  CHILD
AUTHORIZED  FOR  FEE-FOR-SERVICE  COVERAGE  UNDER THE MEDICAL ASSISTANCE
PROGRAM, THE COURT SHALL DETERMINE THE MAXIMUM ANNUAL CASH SUPPORT OBLI-
GATION UNDER SUBCLAUSE (A) OF THIS  CLAUSE,  WHICH  SHALL  BE  EQUAL  TO
TWELVE  TIMES  THE MONTHLY CONTRIBUTION CALCULATED UNDER SUCH SUBCLAUSE.
THE TOTAL AMOUNT OF CASH MEDICAL SUPPORT THAT THE  NON-CUSTODIAL  PARENT
IS ORDERED TO PAY UNDER THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS
OR  HER  GROSS  INCOME,  OR  THE  DIFFERENCE  BETWEEN  THE NON-CUSTODIAL
PARENT'S INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (D) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPHS (I)  AND
(II) OF PARAGRAPH TWO OF SUBDIVISION (E) OF SECTION FOUR HUNDRED SIXTEEN
OF  THE  FAMILY COURT ACT ARE DETERMINED BY THE COURT TO BE UNAVAILABLE,
AND THE CHILD IS DETERMINED ELIGIBLE  FOR  COVERAGE  UNDER  THE  STATE'S
CHILD   HEALTH  INSURANCE  PLAN  PURSUANT  TO  TITLE  ONE-A  OF  ARTICLE
TWENTY-FIVE OF THE PUBLIC HEALTH  LAW,  THE  COURT  SHALL  PRORATE  EACH
PARENT'S  SHARE  OF  THE  COST OF THE FAMILY CONTRIBUTION REQUIRED UNDER
SUCH CHILD HEALTH INSURANCE PLAN IN THE SAME PROPORTION AS EACH PARENT'S
INCOME IS TO THE COMBINED PARENTAL INCOME, AND STATE THE AMOUNT  OF  THE
NON-CUSTODIAL  PARENT'S  SHARE  IN  THE ORDER.   THE COURT MAY ORDER THE
NON-CUSTODIAL PARENT TO PAY HIS OR HER SHARE OF THE FAMILY  CONTRIBUTION
FOR  MONTHS  PRIOR  TO THE ISSUANCE OF THE COURT'S ORDER, UPON A SHOWING
THAT THE CHILD WAS ENROLLED IN THE CHILD HEALTH  INSURANCE  PLAN  DURING
SUCH  MONTHS,  AND  SUCH SHARE SHALL BE SUPPORT ARREARS/PAST DUE SUPPORT
AND SHALL BE SUBJECT TO ANY REMEDIES AS PROVIDED BY LAW FOR THE ENFORCE-
MENT OF SUPPORT ARREARS/PAST DUE SUPPORT.  IN ADDITION, THE COURT  SHALL
PRORATE EACH PARENT'S SHARE OF OTHER HEALTH CARE EXPENSES NOT COVERED BY
THE CHILD HEALTH INSURANCE PLAN, IN THE SAME PROPORTION AS EACH PARENT'S
INCOME  IS  TO THE COMBINED PARENTAL INCOME, AND STATE THE NON-CUSTODIAL
PARENT'S SHARE AS A PERCENTAGE IN THE ORDER.  THE TOTAL AMOUNT  OF  CASH
MEDICAL  SUPPORT  THAT  THE NON-CUSTODIAL PARENT IS ORDERED TO PAY UNDER
THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER GROSS INCOME, OR
THE  DIFFERENCE  BETWEEN  THE  NON-CUSTODIAL  PARENT'S  INCOME  AND  THE
SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (E)  UPON  PROOF BY EITHER PARTY THAT CASH MEDICAL SUPPORT PURSUANT TO
CLAUSES (B), (C), OR (D) OF THIS SUBPARAGRAPH WOULD BE UNJUST  OR  INAP-
PROPRIATE  PURSUANT  TO  PARAGRAPH  (F)  OF  THIS SUBDIVISION, THE COURT
SHALL:
  (A) ORDER THE PARTIES TO PAY CASH MEDICAL SUPPORT AS THE  COURT  FINDS
JUST AND APPROPRIATE, CONSIDERING THE BEST INTERESTS OF THE CHILD; AND
  (B)  SET  FORTH  IN THE ORDER THE FACTORS IT CONSIDERED, THE AMOUNT OF
EACH PARTY'S SHARE OF THE COST, THE REASON OR REASONS THE COURT DID  NOT
ORDER SUCH PRO RATA APPORTIONMENT, AND THE BASIS FOR THE AMOUNT AWARDED.
  S 3. Subdivision (d) of section 416 of the family court act is amended
by adding a new paragraph 3 to read as follows:
  (3) WHEN THE PERSON ON WHOSE BEHALF THE PETITION IS BROUGHT IS A CHILD
IN  ACCORDANCE  WITH  SUBDIVISION  (E) OF THIS SECTION, HEALTH INSURANCE
BENEFITS SHALL BE CONSIDERED "REASONABLE IN COST" IF THE COST OF  HEALTH
INSURANCE BENEFITS DOES NOT EXCEED FIVE PERCENT OF THE COMBINED PARENTAL
GROSS INCOME; PROVIDED, HOWEVER, THIS PRESUMPTION MAY BE REBUTTED UPON A
FINDING THAT THE COST IS UNJUST OR INAPPROPRIATE AND THE COURT SHALL SET

S. 4214                             6

FORTH  THE  REASONS FOR SUCH FINDING IN THE ORDER OF SUPPORT. THE "COST"
OF HEALTH INSURANCE BENEFITS SHALL REFER TO THE COST OF EXTENDING EXIST-
ING HEALTH INSURANCE BENEFITS TO THE CHILD OR CHILDREN, OR  THE  DIFFER-
ENCE  BETWEEN SELF-ONLY BENEFITS AND EXTENDING HEALTH INSURANCE BENEFITS
TO THE CHILD OR CHILDREN WHERE THERE IS NO EXISTING  COVERAGE.    IN  NO
INSTANCE  SHALL  HEALTH  INSURANCE BENEFITS BE CONSIDERED "REASONABLE IN
COST" IF A PARENT'S SHARE OF THE COST OF EXTENDING SUCH  COVERAGE  WOULD
REDUCE  THE INCOME OF THAT PARENT BELOW THE SELF-SUPPORT RESERVE. HEALTH
INSURANCE BENEFITS ARE "REASONABLY ACCESSIBLE" IF THE CHILD LIVES WITHIN
THE GEOGRAPHIC AREA COVERED BY THE PLAN OR LIVES WITHIN FORTY-FIVE MILES
OF SERVICES COVERED BY THE HEALTH INSURANCE BENEFITS OR THROUGH BENEFITS
PROVIDED UNDER A RECIPROCAL AGREEMENT; PROVIDED, HOWEVER, THIS  PRESUMP-
TION MAY BE REBUTTED FOR GOOD CAUSE SHOWN INCLUDING, BUT NOT LIMITED TO,
THE  SPECIAL  HEALTH NEEDS OF THE CHILD.  THE COURT SHALL SET FORTH SUCH
FINDING AND THE REASONS THEREFOR IN THE ORDER OF SUPPORT.
  S 4. Paragraph (b) of subdivision 1 of section  240  of  the  domestic
relations  law  is  amended  by  adding  a new subparagraph 3 to read as
follows:
  (3) WHEN THE PERSON ON WHOSE BEHALF THE PETITION IS BROUGHT IS A CHILD
IN ACCORDANCE WITH PARAGRAPH (C) OF THIS SUBDIVISION,  HEALTH  INSURANCE
BENEFITS  SHALL BE CONSIDERED "REASONABLE IN COST" IF THE COST OF HEALTH
INSURANCE BENEFITS DOES NOT EXCEED FIVE PERCENT OF THE COMBINED PARENTAL
GROSS INCOME; PROVIDED, HOWEVER, THIS PRESUMPTION MAY BE REBUTTED UPON A
FINDING THAT THE COST IS UNJUST OR INAPPROPRIATE AND THE COURT SHALL SET
FORTH THE REASONS FOR SUCH FINDING IN THE ORDER OF SUPPORT.  THE  "COST"
OF HEALTH INSURANCE BENEFITS SHALL REFER TO THE COST OF EXTENDING EXIST-
ING  HEALTH  INSURANCE BENEFITS TO THE CHILD OR CHILDREN, OR THE DIFFER-
ENCE BETWEEN SELF-ONLY BENEFITS AND EXTENDING HEALTH INSURANCE  BENEFITS
TO  THE  CHILD  OR  CHILDREN WHERE THERE IS NO EXISTING COVERAGE.  IN NO
INSTANCE SHALL HEALTH INSURANCE BENEFITS BE  CONSIDERED  "REASONABLE  IN
COST"  IF  A PARENT'S SHARE OF THE COST OF EXTENDING SUCH COVERAGE WOULD
REDUCE THE INCOME OF THAT PARENT BELOW THE SELF-SUPPORT RESERVE.  HEALTH
INSURANCE BENEFITS ARE "REASONABLY ACCESSIBLE" IF THE CHILD LIVES WITHIN
THE GEOGRAPHIC AREA COVERED BY THE PLAN OR LIVES WITHIN FORTY-FIVE MILES
OF SERVICES COVERED BY THE HEALTH INSURANCE BENEFITS OR THROUGH BENEFITS
PROVIDED  UNDER A RECIPROCAL AGREEMENT; PROVIDED, HOWEVER, THIS PRESUMP-
TION MAY BE REBUTTED FOR GOOD CAUSE SHOWN INCLUDING, BUT NOT LIMITED TO,
THE SPECIAL HEALTH NEEDS OF THE CHILD.  THE COURT SHALL SET  FORTH  SUCH
FINDING AND THE REASONS THEREFOR IN THE ORDER OF SUPPORT.
  S  5.  Subparagraph (iii) of paragraph 2 of subdivision (e) of section
416 of the family court act, as added by chapter  624  of  the  laws  of
2002, is amended to read as follows:
  (iii)  If  neither parent has available health insurance benefits, the
court shall direct in the order of support  that  the  custodial  parent
apply  for  the  state's  child  health insurance plan pursuant to title
one-A of article twenty-five of the public health law  and  the  medical
assistance  program established pursuant to title eleven of article five
of the social services law. [If eligible for such  coverage,  the  court
shall  prorate the cost of any premium or family contribution in accord-
ance with subdivision (f) of this section.]  A  direction  issued  under
this  subdivision shall not limit or alter either parent's obligation to
obtain health insurance benefits at such time as they  become  available
as  required  pursuant  to  subdivision (c) of this section.  NOTHING IN
THIS SUBDIVISION SHALL ALTER OR  LIMIT  THE  AUTHORITY  OF  THE  MEDICAL
ASSISTANCE  PROGRAM TO DETERMINE WHEN IT IS CONSIDERED COST EFFECTIVE TO
REQUIRE A CUSTODIAL PARENT TO ENROLL  A  CHILD  IN  AN  AVAILABLE  GROUP

S. 4214                             7

HEALTH  INSURANCE PLAN PURSUANT TO PARAGRAPHS (B) AND (C) OF SUBDIVISION
ONE OF SECTION THREE HUNDRED SIXTY-SEVEN-A OF THE SOCIAL SERVICES LAW.
  S  6. Clause (iii) of subparagraph 2 of paragraph (c) of subdivision 1
of section 240 of the domestic relations law, as amended by chapter  624
of the laws of 2002, is amended to read as follows:
  (iii)  If  neither parent has available health insurance benefits, the
court shall direct in the order of support  that  the  custodial  parent
apply  for  the  state's  child  health insurance plan pursuant to title
one-A of article twenty-five of the public health law  and  the  medical
assistance  program established pursuant to title eleven of article five
of the social services law. [If eligible for such  coverage,  the  court
shall  prorate the cost of any premium or family contribution in accord-
ance with paragraph (d) of this subdivision.] A direction  issued  under
this  subdivision shall not limit or alter either parent's obligation to
obtain health insurance benefits at such time as they become  available,
as  required  pursuant to paragraph (a) of this subdivision.  NOTHING IN
THIS SUBDIVISION SHALL ALTER OR  LIMIT  THE  AUTHORITY  OF  THE  MEDICAL
ASSISTANCE  PROGRAM TO DETERMINE WHEN IT IS CONSIDERED COST EFFECTIVE TO
REQUIRE A CUSTODIAL PARENT TO ENROLL  A  CHILD  IN  AN  AVAILABLE  GROUP
HEALTH INSURANCE PLAN PURSUANT TO PARAGRAPHS (B) AND (C)  OF SUBDIVISION
ONE OF SECTION THREE HUNDRED SIXTY-SEVEN-A OF THE SOCIAL SERVICES LAW.
  S  7.  Subdivision  (f)  of  section  416  of  the family court act is
REPEALED and a new subdivision (f) is added to read as follows:
  (F) THE COST OF PROVIDING HEALTH INSURANCE BENEFITS OR BENEFITS  UNDER
THE  STATE'S  CHILD  HEALTH  INSURANCE  PLAN  OR  THE MEDICAL ASSISTANCE
PROGRAM, PURSUANT TO SUBDIVISION (E) OF THIS SECTION,  SHALL  BE  DEEMED
CASH  MEDICAL  SUPPORT,  AND THE COURT SHALL DETERMINE THE OBLIGATION OF
EITHER OR BOTH PARENTS TO CONTRIBUTE TO THE  COST  THEREOF  PURSUANT  TO
SUBPARAGRAPH  FIVE  OF  PARAGRAPH (C) OF SUBDIVISION ONE OF SECTION FOUR
HUNDRED THIRTEEN OF THIS PART.
  S 8. Paragraph (d) of subdivision 1 of section  240  of  the  domestic
relations  law  is  REPEALED and a new paragraph (d) is added to read as
follows:
  (D) THE COST OF PROVIDING HEALTH INSURANCE BENEFITS OR BENEFITS  UNDER
THE  STATE'S  CHILD  HEALTH  INSURANCE  PLAN  OR  THE MEDICAL ASSISTANCE
PROGRAM, PURSUANT TO PARAGRAPH (C) OF THIS SUBDIVISION, SHALL BE  DEEMED
CASH  MEDICAL  SUPPORT,  AND THE COURT SHALL DETERMINE THE OBLIGATION OF
EITHER OR BOTH PARENTS TO CONTRIBUTE TO THE  COST  THEREOF  PURSUANT  TO
SUBPARAGRAPH FIVE OF PARAGRAPH (C) OF SUBDIVISION ONE-B OF THIS SECTION.
  S  9. Section 514 of the family court act, as amended by chapter 81 of
the laws of 1995, is amended to read as follows:
  S 514. Liability of father to mother. The [father is liable to pay the
reasonable expenses of the mother's confinement and  recovery  and  such
reasonable expenses in connection with her pregnancy as the court in its
discretion may deem proper; provided, however, where] NECESSARY EXPENSES
INCURRED  BY  OR  FOR  THE MOTHER IN CONNECTION WITH HER CONFINEMENT AND
RECOVERY AND THE NECESSARY EXPENSES IN CONNECTION WITH THE PREGNANCY  OF
THE  MOTHER  SHALL  BE  DEEMED CASH MEDICAL SUPPORT, AND THE COURT SHALL
DETERMINE THE OBLIGATION OF EITHER OR BOTH PARENTS TO CONTRIBUTE TO  THE
COST  THEREOF PURSUANT TO SUBPARAGRAPH FIVE OF PARAGRAPH (C) OF SUBDIVI-
SION ONE OF SECTION FOUR HUNDRED THIRTEEN OF THIS ACT. WHERE  the  moth-
er's confinement, recovery and expenses in connection with her pregnancy
were  paid  under the medical assistance program on the mother's behalf,
the father may be liable to the social services district furnishing such
medical assistance and to the  state  department  of  [social  services]
HEALTH  for [the full amount of] medical assistance so expended, [as the

S. 4214                             8

court in its discretion may deem proper] AND THE COURT  SHALL  DETERMINE
THE  OBLIGATION OF THE FATHER TO CONTRIBUTE TO THE COST THEREOF PURSUANT
TO CLAUSE (III) OF SUBPARAGRAPH FIVE OF PARAGRAPH (C) OF SUBDIVISION ONE
OF SECTION FOUR HUNDRED THIRTEEN OF THIS ACT.
  S 10. Subdivision 1 of section 545 of the family court act, as amended
by chapter 214 of the laws of 1998, is amended to read as follows:
  1.  In a proceeding in which the court has made an order of filiation,
the court shall direct the parent or  parents  possessed  of  sufficient
means or able to earn such means to pay weekly or at other fixed periods
a  fair  and  reasonable  sum according to their respective means as the
court may determine and apportion for such child's  support  and  educa-
tion,  until the child is twenty-one. The order shall be effective as of
the earlier of the date of the application for an  order  of  filiation,
or,  if the children for whom support is sought are in receipt of public
assistance, the date for which their eligibility for  public  assistance
was  effective. Any retroactive amount of child support shall be support
arrears/past-due support and shall be paid in one sum or  periodic  sums
as  the  court shall direct, taking into account any amount of temporary
support which has been paid. In addition, such retroactive child support
shall be enforceable in any manner provided by law  including,  but  not
limited to, an execution for support enforcement pursuant to subdivision
(b) of section fifty-two hundred forty-one of the civil practice law and
rules.   The court shall direct such parent to make his or her residence
known at all times should he or she move from the address last known  to
the court by reporting such change to the support collection unit desig-
nated  by  the  appropriate  social  services  district. The order shall
contain the social security numbers of the named parents. The order  may
also  direct each parent to pay an amount as the court may determine and
apportion for the support of the child prior to the making of the  order
of  filiation,  and may direct each parent to pay an amount as the court
may determine and apportion for [(i)] the funeral expenses if the  child
has  died[;  (ii)  the].  THE  necessary expenses incurred by or for the
mother in connection with her confinement  and  recovery[;]  and  [(iii)
such]  THE  NECESSARY  expenses  in connection with the pregnancy of the
mother [as the court may deem  proper]  SHALL  BE  DEEMED  CASH  MEDICAL
SUPPORT,  AND THE COURT SHALL DETERMINE THE OBLIGATION OF EITHER OR BOTH
PARENTS TO CONTRIBUTE TO THE COST THEREOF PURSUANT TO SUBPARAGRAPH  FIVE
OF  PARAGRAPH (C) OF SUBDIVISION ONE OF SECTION FOUR HUNDRED THIRTEEN OF
THIS ACT.   WHERE THE MOTHER'S CONFINEMENT,  RECOVERY  AND  EXPENSES  IN
CONNECTION  WITH  HER  PREGNANCY  WERE PAID UNDER THE MEDICAL ASSISTANCE
PROGRAM ON THE MOTHER'S BEHALF, THE FATHER MAY BE LIABLE TO  THE  SOCIAL
SERVICES  DISTRICT  FURNISHING  SUCH MEDICAL ASSISTANCE AND TO THE STATE
DEPARTMENT OF HEALTH FOR MEDICAL ASSISTANCE SO EXPENDED, AND  THE  COURT
SHALL  DETERMINE  THE OBLIGATION OF THE FATHER TO CONTRIBUTE TO THE COST
THEREOF PURSUANT TO CLAUSE (III) OF SUBPARAGRAPH FIVE OF  PARAGRAPH  (C)
OF  SUBDIVISION  ONE  OF  SECTION  FOUR HUNDRED THIRTEEN OF THIS ACT. In
addition, the court shall make provisions for health insurance  benefits
in  accordance  with the requirements of section four hundred sixteen of
this act.
  S 11. Subparagraph (i) of paragraph 2 of subdivision  (b)  of  section
5241  of  the civil practice law and rules, as amended by chapter 533 of
the laws of 1999, is amended to read as follows:
  (i) Where the court orders the  debtor  to  provide  health  insurance
benefits  for  specified  dependents,  an  execution for medical support
enforcement may, except as provided for herein, be issued by the support
collection unit, or by the sheriff, the clerk of court or  the  attorney

S. 4214                             9

for  the  creditor  as  an officer of the court; provided, however, that
when the court issues an order of child support or  combined  child  and
spousal  support  on  behalf  of  persons other than those in receipt of
public  assistance  or  in  receipt  of services pursuant to section one
hundred eleven-g of the social  services  law,  such  medical  execution
shall be in the form of a separate qualified medical child support order
as  provided by subdivision [(f)] (J) of section four hundred sixteen of
the family court act and paragraph  [(f)]  (H)  of  subdivision  one  of
section  two hundred forty of the domestic relations law. Such execution
for medical support  enforcement  may  require  the  debtor's  employer,
organization or group health plan administrator to purchase on behalf of
the  debtor  and the debtor's dependents such available health insurance
benefits. Such execution shall  direct  the  employer,  organization  or
group  health  plan  administrator to provide to the dependents for whom
such benefits are required to be provided or such dependents'  custodial
parent  or  legal  guardian  or  social  services  district on behalf of
persons applying for or in receipt of public assistance any  identifica-
tion  cards  and  benefit  claim forms and to withhold from the debtor's
income the employee's share of the cost of such health  insurance  bene-
fits,  and to provide written confirmation of such enrollment indicating
the date such benefits were or become available or  that  such  benefits
are  not  available  and  the  reasons  therefor  to  the  issuer of the
execution. An  execution  for  medical  support  enforcement  shall  not
require  a debtor's employer, organization or group health plan adminis-
trator to purchase or  otherwise  acquire  health  insurance  or  health
insurance  benefits  that would not otherwise be available to the debtor
by reason of his or her employment or membership. Nothing  herein  shall
be  deemed  to  obligate or otherwise hold any employer, organization or
group health plan administrator responsible for an option  exercised  by
the  debtor  in  selecting  medical insurance coverage by an employee or
member.
  S 12. Subdivision (h) of section 5241 of the civil  practice  law  and
rules, as amended by chapter 398 of the laws of 1997, is amended to read
as follows:
  (h)  Priority.  A levy pursuant to this section or an income deduction
order pursuant to section 5242 of this chapter shall take priority  over
any other assignment, levy or process. If an employer or income payor is
served with more than one execution pursuant to this section, or with an
execution pursuant to this section and also an order pursuant to section
5242 of this chapter, and if the combined total amount of the deductions
to  be  withheld exceeds the limits set forth in subdivision (g) of this
section, the employer or income payor shall withhold the maximum  amount
permitted thereby and pay to each creditor that proportion thereof which
such  creditor's  claim  bears  to  the  combined  total. Any additional
deduction authorized by subdivision (g) of this section to be applied to
the reduction of arrears shall be applied to such arrears in  proportion
to  the  amount  of  arrears due to each creditor. Deductions to satisfy
CURRENT  support  obligations[,  including  any  additional   deductions
authorized by subdivision (g) of this section,] shall have priority over
deductions   for  the  debtor's  share  of  health  insurance  premiums.
DEDUCTIONS TO SATISFY HEALTH INSURANCE PREMIUMS SHALL HAVE PRIORITY OVER
DEDUCTIONS FOR ARREARS AUTHORIZED BY SUBDIVISION (G) OF THIS SECTION.
  S 13. This act shall take effect on the ninetieth day after  it  shall
have  become  a  law  and  shall apply to any proceeding to establish or
modify a child support obligation, including  a  medical  support  obli-
gation, commenced after that date.

2009-S4214A - Details

Law Section:: Family Court Act
Laws Affected:: Rpld & add §413 sub 1 ¶(c) sub¶ 5, §416 sub (f), amd §§416, 514 & 545, Fam Ct Act; rpld & add §240 sub 1-b ¶(c) sub¶ 5, sub 1 ¶(d), amd §240, Dom Rel L; amd §5241, CPLR

2009-S4214A - Summary

Establishes definitions for "cash medical support", "reasonable in cost" and "reasonably accessible"; amends the priority for deductions via an income execution.

2009-S4214A - Sponsor Memo

                                 BILL NUMBER:  S4214A

 TITLE OF BILL :

An act to amend the family court act and the domestic relations law,
in relation to establishing definitions for "cash medical support",
and when health insurance benefits are "reasonable in cost" and
"reasonably accessible"; to amend the civil practice law and rules, in
relation to amending the priority for deductions via an income
execution; and to repeal certain provisions of the family court act
and the domestic relations law relating thereto


 PURPOSE OF THE BILL :

This bill would enact federal mandates set forth in the final medical
support regulations for the child support enforcement program,
released by the federal Department of Health and Human Services on
July 21, 2008. The federal regulations require each state to define
when private health insurance benefits, an element of support, are
"reasonable in cost" and when such health insurance shall be
considered "reasonably accessible."

 SUMMARY OF PROVISIONS :

Sections 1 and 2 of the bill would amend section 413 of the Family

Court Act (FCA) and section 240 of the Domestic Relations Law (DRL),
respectively, to require the court to determine the availability of
private health insurance benefits, define the term "cash medical
support," and provide an income-based numeric standard for determining
when cash medical support should be ordered and the amount of each
parent's contribution. For children enrolled in the State Child Health
Insurance Program (SCHIP), the portion of cash medical support
attributable to public coverage is the pro rata share of the family
contribution under the State's child health insurance plan. For
children enrolled in the Medical Assistance (MA) program, the
non-custodial parent's obligation for the portion of cash medical
support attributable to public benefits is the lesser of (1) the
amount that would be required under SCHIP using the combined income of
the parents as if the child(ren) were in a two-parent household; or,
(2) the actual amount expended by the MA program. For children
enrolled in ·either program, the total cash medical support obligation
for costs attributable to public coverage or benefits shall not exceed
5% of the non-custodial parent's income or reduce the parent's income
below the self-support reserve.

Sections 3 and 4 of the bill would amend section 416 of the FCA and
section 240 of the DRL, respectively, to define the terms "reasonable
in cost" and "reasonably accessible," to aid the court in determining
whether private health insurance benefits are available to a child.

Sections 5 and 6 of the bill would amend section 416( e )(2)(iii) of
the FCA and section 240(1)(c)(2)(iii) of the DRL. These sections
provide that when private health insurance benefits are unavailable,
the custodial parent must be directed to apply for SCRIP or MA. The
current language allowing the court to apportion the cost of any
premium, family contribution, or health expense associated with
participation in such plan or program is deleted.

Sections 7 and 8 of the bill would amend section 416(f) of the FCA and
section 240(1)(d) of the DRL. These sections currently provide for the
proration of costs between the parties where private health insurance
is ordered. The subdivisions are amended 'to state that the cost of
private health insurance, or the cost of any premium, family
contribution, or health expense incurred as a result of enrollment in
SCRIP or the MA program shall be deemed cash medical support and each
parent's contribution will be determined under the amended provisions
in sections 1 and 2 of this bill.

Sections 9 and 10 of the bill would amend sections 514 and 545 of the
FCA, respectively, to provide that the necessary expenses incurred by
or for the mother in connection with her pregnancy, confinement and
recovery shall be deemed a cash medical support obligation and the
court shall determine the obligation of either or both parties to
contribute to the cost pursuant to section 413 of the FCA, the Child
Support Standards Act.

Section 11 of the bill would amend section 5241 (b)(2)(i) of the Civil
Practice Law and Rules (CPLR) to correct a statutory reference.

Section 12 of the bill would amend section 5241(h) of the CPLR to
revise the priority of deductions made by an employer or income payor
in response to an income execution, medical support execution or
income deduction order. Under this bill, the employer will first
deduct the amount due for current child support obligations, then the
cost of health insurance premiums, then the additional amount to
reduce support arrears.

Section 13 of the bill would provide that the amendments would be
effective on the ninetieth day after it shall become law and apply to
any proceeding to establish or modify a child support obligation,
including a medical support obligation, commenced on or after that
date.

 EXISTING LAW :

Various sections of the FCA, the DRL and the Social Services Law (SSL)
contain provisions concerning the obligation of parents to support
their children and provide procedures for the establishment of
paternity and the establishment, enforcement and modification of child
support obligations, including the cost of health insurance coverage
and other health care expenses. Section 5241 of the CPLR contains the
procedure associated with utilizing income executions and medical
support executions for support enforcement.

 PRIOR LEGISLATIVE HISTORY :

In the 2008 Legislative Session, provisions similar to sections three
and four of this bill were part of S.8340, but S.8340 was not reported
from the Senate Rules Committee.

 STATEMENT IN SUPPORT :

The provision of health insurance benefits and medical support is an
important component of child support. This bill would allow New York
to comply with the federal final rules (45 CFR 302.56; 303.31)
pertaining to medical support, which requires states to define the
terms "reasonable in cost" and "reasonably accessible" in relation to
the availability of private health insurance, and also the federal
mandate to set a reasonable income-based numeric standard for
determining when cash medical support should be ordered.

Under federal regulations, private health insurance is considered
"available" when it is reasonable in cost and reasonably accessible as
those terms are defined by a state. In the event that private health
insurance is not "available", the regulations mandate that states seek
an order for "cash medical support" until such time as private health
insurance becomes available. Additionally, the final medical support
regulations allow states to define when it is appropriate to seek cash
medical support in addition to private health insurance benefits.


This bill would define "cash medical support" under the child support
standards as the amount to be paid for the cost of health insurance
provided by a public entity or by a parent through an employer or
organization, and/or for other health care costs not covered by
insurance. It sets out the method of apportioning the cost of the
different types of cash medical support, such as private health
insurance premiums, benefits provided by the SCRIP and the MA program,
as well as health care expenses not covered by health insurance. The
bill also limits the establishment of cash medical support obligations
in support orders so that the non-custodial parent's income will not
be reduced below the self-support reserve (135% of the federal poverty
income guidelines for a single person).

This bill would adopt the federal option for the State definition of
cash medical support and provide a method for the court to determine
the parties' obligation to provide each of the three types of cash
medical support. First, if private health insurance benefits are
determined by a court to be "available" (i.e., 5% or less of the
parties' gross income), the court must order the non-custodial parent
to pay his or her pro rata share of the health insurance premium. The
primary goal of these provisions is to ensure that private health
insurance is utilized when available at reasonable cost. The use of
private health insurance may reduce the cost of health care for the
child expended by the parents and the public.

Second, if the child covered by private health insurance incurs
additional unreimbursed health care expenses, the court shall order
the non-custodial parent to pay his or her pro rata share of the
reasonable cash medical support expenses. Orders requiring the
non-custodial parent to pay his or her share of unreimbursed health
care expenses are currently a mandatory provision under the Child
Support Standards Act.  The bill continues this obligation. When
combined with the cost to the parent for private health insurance or
public coverage, the total payment ordered by the court for cash
medical support may not cause his or her income to fall below the
self-support reserve.

Third, where private health insurance benefits are determined by the
court not to be "available," the custodial parent will be ordered, in
accordance with current law, to apply for SCHIP or MA. If the child is
determined eligible for SCHIP, the portion of cash medical support
associated with public coverage or benefits is the prorated share of
the family contribution under SCHIP. For children enrolled in MA
(regardless of whether it is managed care or fee-for-service), the
non-custodial parent's obligation towards the portion of cash medical
support for public coverage or benefits is the lesser of the amount
that would be required under SCHIP using the combined income of the
parents as if the child(ren) were in a two-parent household, or the
actual amount expended by the MA program. In managed care cases, the
court will order a monthly obligation for the portion of cash medical
support associated with public coverage. In fee-for-service cases, for
the portion of cash medical support associated with public coverage,
the court will set forth in the order the maximum annual cash support
obligation based on the amount that would be required under SCHIP in a
two-parent household. For children enrolled in either program, in no
case shall the cash medical support obligation for public coverage or
benefits exceed 5% of the non-custodial parent's gross income, or the
difference between the non-custodial parent's income and the
self-support reserve, whichever is less.

The bill would also define two terms that are considered by courts in
determining whether private health insurance benefits are available to
a child. Private health insurance benefits must be "reasonable in
cost" and "reasonably accessible" in order to be deemed available.


The first term, "reasonable in cost," is defined in this bill to mean
that the cost of premiums and deductibles for private health insurance
attributable to the child(ren) does not exceed five percent of the
combined parental gross income. However, no benefits will be
considered "reasonable in cost" if the cost to a parent of extending
coverage to the child(ren) would reduce the income of that parent
below the self-support reserve. In addition, upon a finding of the
court that the cost borne by a parent is unjust or inappropriate, the
presumption of cost-reasonableness may be rebutted.

Pursuant to the federal regulations, where the child(ren) will be
added to existing benefits, the "cost" to be considered in determining
reasonableness is the cost of adding the child who is the subject of
the order. However, where there is no existing coverage, the "cost" to
be considered in determining reasonableness is the difference between
self only (individual) benefits and health insurance benefits which
extend to all the children who are the subject of the order. This
would include determining the portion of any deductible attributable
to the child(ren) which should be considered for purposes of this
analysis. Only the incremental increase in the deductible associated
with adding the child(ren) to existing coverage or, where no coverage
currently exists, the incremental difference between the deductible
for self-only coverage and coverage extending to the child, is to be
considered. While some employment-based coverage may require the
employee to enroll in self-coverage in order to cover his/her
dependents, pursuant the applicable federal regulations, the cost
associated with such coverage mandated by the plan is not to be
considered in the determination as to whether private health insurance
is "reasonable in cost." Only the incremental cost associated with
coverage for the child(ren) is to be considered.

"Reasonably accessible" is defined to mean that the child lives within
the geographic area covered by the plan or lives within thirty minutes
or thirty miles of services covered by the health insurance benefits
or through benefits provided under a reciprocal agreement.  The
presumption of accessibility may be rebutted for good cause shown
which may include, but is not limited to, a consideration of the
special health needs of the subject child.

In addition to complying with the federal mandate, these provisions
will improve child support orders. Currently, the courts do not have a
standard definition of reasonable cost. Different courts apply
different standards, and even calculate the cost of health insurance
differently. Greater consistency in determining whether health
insurance is' available - that is, reasonable in cost and reasonably
accessible - is anticipated as a result of this bill. In addition, the
court is given flexibility to address the parties' individual
circumstances and set an order that is just and appropriate.

The bill would also clarify that the cost of private health insurance
premiums or any premium, family contribution, or health expense
associated with enrollment of a child in SCRIP or MA is cash medical
support. The proposed amendments refer the court to the Child Support
Standards Act to calculate the amount of each parties' contribution to
the cost of these expenses.

The bill would further clarify that the necessary expenses incurred by
or for the mother in connection with her pregnancy, confinement and
recovery are a cash medical support obligation to the father. Where
these expenses were paid under the MA program on the mother's behalf,
the father's liability to the social services district and the State
will be subject to the same cap and low income protections as cash
medical support for other MA expenses.

Finally, the bill amends the priorities for income withholding by an
employer or other income payor. Consistent with the goal of providing
private health insurance benefits whenever possible, deductions to
satisfy support obligations will have the following priority: (1)
current support obligations (2) health insurance premiums; (3)
arrears.

 BUDGET IMPLICATIONS :

Failure to pass this bill will put the State out of IV-D Plan
compliance and subject the State to elimination of federal
reimbursement.

 EFFECTIVE DATE :
The bill would take effect on the ninetieth day after it shall become
law and apply to any proceeding to establish or modify a child support
obligation, including a medical support obligation, commenced on or
after that date.

2009-S4214A - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4214--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             April 17, 2009
                               ___________

Introduced by Sen. SAMPSON -- (at request of the Office of Temporary and
  Disability  Assistance)  --  read  twice and ordered printed, and when
  printed to be committed to the  Committee  on  Judiciary  --  reported
  favorably  from  said  committee  and  committed  to  the Committee on
  Finance -- committee discharged, bill amended,  ordered  reprinted  as
  amended and recommitted to said committee

AN  ACT to amend the family court act and the domestic relations law, in
  relation to establishing definitions for "cash medical  support",  and
  when  health  insurance benefits are "reasonable in cost" and "reason-
  ably accessible"; to amend  the  civil  practice  law  and  rules,  in
  relation  to  amending  the  priority  for  deductions  via  an income
  execution; and to repeal certain provisions of the  family  court  act
  and the domestic relations law relating thereto

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subparagraph 5 of paragraph (c) of subdivision 1 of section
413 of the family court act is REPEALED and  a  new  subparagraph  5  is
added to read as follows:
  (5)  THE  COURT  SHALL  DETERMINE  THE  PARTIES' OBLIGATION TO PROVIDE
HEALTH INSURANCE BENEFITS PURSUANT TO SECTION FOUR  HUNDRED  SIXTEEN  OF
THIS PART AND TO PAY CASH MEDICAL SUPPORT AS PROVIDED UNDER THIS SUBPAR-
AGRAPH.
  (I)  "CASH  MEDICAL SUPPORT" MEANS AN AMOUNT ORDERED TO BE PAID TOWARD
THE COST OF HEALTH INSURANCE PROVIDED BY A PUBLIC ENTITY OR BY A  PARENT
THROUGH  AN EMPLOYER OR ORGANIZATION, INCLUDING SUCH EMPLOYERS OR ORGAN-
IZATIONS WHICH ARE SELF  INSURED,  OR  THROUGH  OTHER  AVAILABLE  HEALTH
INSURANCE  OR  HEALTH  CARE COVERAGE PLANS, AND/OR FOR OTHER HEALTH CARE
EXPENSES NOT COVERED BY INSURANCE.
  (II) WHERE HEALTH INSURANCE BENEFITS PURSUANT  TO  PARAGRAPH  ONE  AND
SUBPARAGRAPHS  (I)  AND  (II)  OF  PARAGRAPH  TWO  OF SUBDIVISION (E) OF
SECTION FOUR HUNDRED SIXTEEN OF THIS PART ARE DETERMINED BY THE COURT TO

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07704-08-9

S. 4214--A                          2

BE AVAILABLE, THE COST OF PROVIDING HEALTH INSURANCE BENEFITS  SHALL  BE
PRORATED  BETWEEN  THE  PARTIES  IN THE SAME PROPORTION AS EACH PARENT'S
INCOME IS TO THE COMBINED PARENTAL INCOME. IF THE  CUSTODIAL  PARENT  IS
ORDERED  TO  PROVIDE  SUCH BENEFITS, THE NON-CUSTODIAL PARENT'S PRO RATA
SHARE OF SUCH COSTS SHALL BE ADDED TO THE BASIC SUPPORT  OBLIGATION.  IF
THE NON-CUSTODIAL PARENT IS ORDERED TO PROVIDE SUCH BENEFITS, THE CUSTO-
DIAL  PARENT'S  PRO  RATA SHARE OF SUCH COSTS SHALL BE DEDUCTED FROM THE
BASIC SUPPORT OBLIGATION.
  (III) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO  PARAGRAPH  ONE  AND
SUBPARAGRAPHS  (I)  AND  (II)  OF  PARAGRAPH  TWO  OF SUBDIVISION (E) OF
SECTION FOUR HUNDRED SIXTEEN OF THIS PART ARE DETERMINED BY THE COURT TO
BE UNAVAILABLE, IF THE CHILD OR CHILDREN  ARE  DETERMINED  ELIGIBLE  FOR
COVERAGE  UNDER  THE  MEDICAL ASSISTANCE PROGRAM ESTABLISHED PURSUANT TO
TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW, THE COURT SHALL
ORDER THE NON-CUSTODIAL PARENT TO PAY CASH MEDICAL SUPPORT AS FOLLOWS:
  (A) IN THE CASE OF A CHILD OR CHILDREN  AUTHORIZED  FOR  MANAGED  CARE
COVERAGE  UNDER THE MEDICAL ASSISTANCE PROGRAM, THE LESSER OF THE AMOUNT
THAT WOULD BE REQUIRED AS A FAMILY CONTRIBUTION UNDER THE STATE'S  CHILD
HEALTH  INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF
THE PUBLIC HEALTH LAW FOR THE CHILD  OR  CHILDREN  IF  THEY  WERE  IN  A
TWO-PARENT  HOUSEHOLD  WITH  INCOME  EQUAL TO THE COMBINED INCOME OF THE
NON-CUSTODIAL AND CUSTODIAL PARENTS OR THE PREMIUM PAID BY  THE  MEDICAL
ASSISTANCE  PROGRAM  ON  BEHALF  OF THE CHILD OR CHILDREN TO THE MANAGED
CARE PLAN. THE COURT SHALL SEPARATELY STATE THE  NON-CUSTODIAL  PARENT'S
MONTHLY  OBLIGATION.  THE  NON-CUSTODIAL  PARENT'S  CASH MEDICAL SUPPORT
OBLIGATION UNDER THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER
GROSS INCOME, OR  THE  DIFFERENCE  BETWEEN  THE  NON-CUSTODIAL  PARENT'S
INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (B)  IN THE CASE OF A CHILD OR CHILDREN AUTHORIZED FOR FEE-FOR-SERVICE
COVERAGE UNDER THE MEDICAL ASSISTANCE PROGRAM  OTHER  THAN  A  CHILD  OR
CHILDREN DESCRIBED IN ITEM (A) OF THIS CLAUSE, THE COURT SHALL DETERMINE
THE  NON-CUSTODIAL  PARENT'S  MAXIMUM  ANNUAL CASH MEDICAL SUPPORT OBLI-
GATION, WHICH SHALL BE EQUAL TO THE LESSER OF THE  MONTHLY  AMOUNT  THAT
WOULD  BE  REQUIRED  AS  A  FAMILY  CONTRIBUTION UNDER THE STATE'S CHILD
HEALTH INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE  OF
THE  PUBLIC  HEALTH  LAW  FOR  THE  CHILD  OR CHILDREN IF THEY WERE IN A
TWO-PARENT HOUSEHOLD WITH INCOME EQUAL TO THE  COMBINED  INCOME  OF  THE
NON-CUSTODIAL AND CUSTODIAL PARENTS TIMES TWELVE MONTHS OR THE NUMBER OF
MONTHS  THAT  THE  CHILD  OR CHILDREN ARE AUTHORIZED FOR FEE-FOR-SERVICE
COVERAGE DURING ANY YEAR. THE COURT SHALL SEPARATELY STATE IN THE  ORDER
THE  NON-CUSTODIAL  PARENT'S  MAXIMUM  ANNUAL CASH MEDICAL SUPPORT OBLI-
GATION AND, UPON PROOF TO THE COURT THAT THE NON-CUSTODIAL PARENT, AFTER
NOTICE OF THE AMOUNT DUE, HAS  FAILED  TO  PAY  THE  PUBLIC  ENTITY  FOR
INCURRED  HEALTH  CARE EXPENSES, THE COURT SHALL ORDER THE NON-CUSTODIAL
PARENT TO PAY SUCH INCURRED HEALTH CARE EXPENSES UP TO THE MAXIMUM ANNU-
AL CASH MEDICAL  SUPPORT  OBLIGATION.  SUCH  AMOUNTS  SHALL  BE  SUPPORT
ARREARS/PAST  DUE  SUPPORT  AND  SHALL  BE  SUBJECT  TO  ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
THE TOTAL ANNUAL AMOUNT THAT THE NON-CUSTODIAL PARENT IS ORDERED TO  PAY
UNDER  THIS  CLAUSE  SHALL  NOT  EXCEED FIVE PERCENT OF HIS OR HER GROSS
INCOME OR THE DIFFERENCE BETWEEN THE NON-CUSTODIAL PARENT'S  INCOME  AND
THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (C)  THE COURT SHALL ORDER CASH MEDICAL SUPPORT TO BE PAID BY THE NON-
CUSTODIAL PARENT FOR HEALTH CARE EXPENSES OF THE CHILD OR CHILDREN  PAID
BY  THE  MEDICAL ASSISTANCE PROGRAM PRIOR TO THE ISSUANCE OF THE COURT'S
ORDER. THE AMOUNT OF SUCH SUPPORT SHALL BE CALCULATED AS PROVIDED  UNDER

S. 4214--A                          3

ITEM  (A)  OR  (B)  OF  THIS  CLAUSE,  PROVIDED THAT THE AMOUNT THAT THE
NON-CUSTODIAL PARENT IS ORDERED TO PAY UNDER THIS ITEM SHALL NOT  EXCEED
FIVE  PERCENT  OF  HIS OR HER GROSS INCOME OR THE DIFFERENCE BETWEEN THE
NON-CUSTODIAL PARENT'S INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS
LESS,  FOR THE YEAR WHEN THE EXPENSE WAS INCURRED. SUCH AMOUNTS SHALL BE
SUPPORT ARREARS/PAST DUE SUPPORT AND SHALL BE SUBJECT TO ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
  (IV) WHERE HEALTH INSURANCE BENEFITS PURSUANT  TO  PARAGRAPH  ONE  AND
SUBPARAGRAPHS  (I)  AND  (II)  OF  PARAGRAPH  TWO  OF SUBDIVISION (E) OF
SECTION FOUR HUNDRED SIXTEEN OF THIS PART ARE DETERMINED BY THE COURT TO
BE UNAVAILABLE, AND THE CHILD OR CHILDREN ARE  DETERMINED  ELIGIBLE  FOR
COVERAGE UNDER THE STATE'S CHILD HEALTH INSURANCE PLAN PURSUANT TO TITLE
ONE-A  OF  ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, THE COURT SHALL
PRORATE EACH PARENT'S SHARE OF  THE  COST  OF  THE  FAMILY  CONTRIBUTION
REQUIRED  UNDER  SUCH CHILD HEALTH INSURANCE PLAN IN THE SAME PROPORTION
AS EACH PARENT'S INCOME IS TO THE COMBINED PARENTAL  INCOME,  AND  STATE
THE  AMOUNT  OF THE NON-CUSTODIAL PARENT'S SHARE IN THE ORDER. THE TOTAL
AMOUNT OF CASH MEDICAL SUPPORT THAT THE NON-CUSTODIAL PARENT IS  ORDERED
TO  PAY  UNDER  THIS  CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER
GROSS INCOME, OR  THE  DIFFERENCE  BETWEEN  THE  NON-CUSTODIAL  PARENT'S
INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (V)  IN  ADDITION  TO THE AMOUNTS ORDERED UNDER CLAUSE (II), (III), OR
(IV) OF THIS SUBPARAGRAPH, THE COURT SHALL PRO RATE EACH PARENT'S  SHARE
OF  REASONABLE HEALTH CARE EXPENSES NOT REIMBURSED OR PAID BY INSURANCE,
THE MEDICAL ASSISTANCE PROGRAM ESTABLISHED PURSUANT TO TITLE  ELEVEN  OF
ARTICLE  FIVE  OF  THE  SOCIAL SERVICES LAW, OR THE STATE'S CHILD HEALTH
INSURANCE PLAN PURSUANT TO TITLE ONE-A OF  ARTICLE  TWENTY-FIVE  OF  THE
PUBLIC  HEALTH LAW, IN THE SAME PROPORTION AS EACH PARENT'S INCOME IS TO
THE COMBINED PARENTAL INCOME, AND STATE THE NON-CUSTODIAL PARENT'S SHARE
AS A PERCENTAGE IN THE ORDER. THE NON-CUSTODIAL PARENT'S PRO RATA  SHARE
OF SUCH HEALTH CARE EXPENSES DETERMINED BY THE COURT TO BE DUE AND OWING
SHALL  BE  SUPPORT  ARREARS/PAST DUE SUPPORT AND SHALL BE SUBJECT TO ANY
REMEDIES PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE
SUPPORT. IN ADDITION,  THE  COURT  MAY  DIRECT  THAT  THE  NON-CUSTODIAL
PARENT'S  PRO RATA SHARE OF SUCH HEALTH CARE EXPENSES BE PAID IN ONE SUM
OR IN PERIODIC SUMS, INCLUDING DIRECT PAYMENT TO THE HEALTH CARE PROVID-
ER.
  (VI) UPON PROOF BY EITHER PARTY THAT CASH MEDICAL SUPPORT PURSUANT  TO
CLAUSE  (II), (III), (IV) OR (V) OF THIS SUBPARAGRAPH WOULD BE UNJUST OR
INAPPROPRIATE PURSUANT TO PARAGRAPH  (F)  OF  SUBDIVISION  ONE  OF  THIS
SECTION, THE COURT SHALL:
  (A)  ORDER  THE PARTIES TO PAY CASH MEDICAL SUPPORT AS THE COURT FINDS
JUST AND APPROPRIATE, CONSIDERING THE BEST INTERESTS OF THE CHILD; AND
  (B) SET FORTH IN THE ORDER  THE  FACTORS  IT  CONSIDERED,  THE  AMOUNT
CALCULATED  UNDER THIS SUBPARAGRAPH, THE REASON OR REASONS THE COURT DID
NOT ORDER SUCH AMOUNT, AND THE BASIS FOR THE AMOUNT AWARDED.
  S 2. Subparagraph 5 of paragraph (c) of subdivision 1-b of section 240
of the domestic relations law is REPEALED and a new  subparagraph  5  is
added to read as follows:
  (5)  THE  COURT  SHALL  DETERMINE  THE  PARTIES' OBLIGATION TO PROVIDE
HEALTH INSURANCE BENEFITS PURSUANT TO  THIS  SECTION  AND  TO  PAY  CASH
MEDICAL SUPPORT AS PROVIDED UNDER THIS SUBPARAGRAPH.
  (I)  "CASH  MEDICAL SUPPORT" MEANS AN AMOUNT ORDERED TO BE PAID TOWARD
THE COST OF HEALTH INSURANCE PROVIDED BY A PUBLIC ENTITY OR BY A  PARENT
THROUGH  AN EMPLOYER OR ORGANIZATION, INCLUDING SUCH EMPLOYERS OR ORGAN-
IZATIONS WHICH ARE SELF  INSURED,  OR  THROUGH  OTHER  AVAILABLE  HEALTH

S. 4214--A                          4

INSURANCE  OR  HEALTH  CARE COVERAGE PLANS, AND/OR FOR OTHER HEALTH CARE
EXPENSES NOT COVERED BY INSURANCE.
  (II)  WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPH ONE AND
CLAUSES (I) AND (II) OF SUBPARAGRAPH TWO OF PARAGRAPH (C) OF SUBDIVISION
ONE OF THIS SECTION ARE DETERMINED BY THE COURT  TO  BE  AVAILABLE,  THE
COST  OF  PROVIDING  HEALTH INSURANCE BENEFITS SHALL BE PRORATED BETWEEN
THE PARTIES IN THE SAME PROPORTION AS EACH PARENT'S  INCOME  IS  TO  THE
COMBINED  PARENTAL INCOME. IF THE CUSTODIAL PARENT IS ORDERED TO PROVIDE
SUCH BENEFITS, THE NON-CUSTODIAL PARENT'S PRO RATA SHARE OF  SUCH  COSTS
SHALL  BE  ADDED  TO  THE BASIC SUPPORT OBLIGATION. IF THE NON-CUSTODIAL
PARENT IS ORDERED TO PROVIDE SUCH BENEFITS, THE CUSTODIAL  PARENT'S  PRO
RATA  SHARE OF SUCH COSTS SHALL BE DEDUCTED FROM THE BASIC SUPPORT OBLI-
GATION.
  (III) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPH ONE AND
CLAUSES (I) AND (II) OF SUBPARAGRAPH TWO OF PARAGRAPH (C) OF SUBDIVISION
ONE OF THIS SECTION ARE DETERMINED BY THE COURT TO  BE  UNAVAILABLE,  IF
THE  CHILD  OR  CHILDREN  ARE DETERMINED ELIGIBLE FOR COVERAGE UNDER THE
MEDICAL ASSISTANCE PROGRAM ESTABLISHED PURSUANT TO TITLE ELEVEN OF ARTI-
CLE FIVE OF THE SOCIAL SERVICES LAW, THE COURT SHALL ORDER THE  NON-CUS-
TODIAL PARENT TO PAY CASH MEDICAL SUPPORT AS FOLLOWS:
  (A)  IN  THE  CASE  OF A CHILD OR CHILDREN AUTHORIZED FOR MANAGED CARE
COVERAGE UNDER THE MEDICAL ASSISTANCE PROGRAM, THE LESSER OF THE  AMOUNT
THAT  WOULD BE REQUIRED AS A FAMILY CONTRIBUTION UNDER THE STATE'S CHILD
HEALTH INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE  OF
THE  PUBLIC  HEALTH  LAW  FOR  THE  CHILD  OR CHILDREN IF THEY WERE IN A
TWO-PARENT HOUSEHOLD WITH INCOME EQUAL TO THE  COMBINED  INCOME  OF  THE
NON-CUSTODIAL  AND  CUSTODIAL PARENTS OR THE PREMIUM PAID BY THE MEDICAL
ASSISTANCE PROGRAM ON BEHALF OF THE CHILD OR  CHILDREN  TO  THE  MANAGED
CARE  PLAN.  THE COURT SHALL SEPARATELY STATE THE NON-CUSTODIAL PARENT'S
MONTHLY OBLIGATION. THE  NON-CUSTODIAL  PARENT'S  CASH  MEDICAL  SUPPORT
OBLIGATION UNDER THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER
GROSS  INCOME,  OR  THE  DIFFERENCE  BETWEEN  THE NON-CUSTODIAL PARENT'S
INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (B) IN THE CASE OF A CHILD OR CHILDREN AUTHORIZED FOR  FEE-FOR-SERVICE
COVERAGE  UNDER  THE  MEDICAL  ASSISTANCE  PROGRAM OTHER THAN A CHILD OR
CHILDREN DESCRIBED IN ITEM (A) OF THIS CLAUSE, THE COURT SHALL DETERMINE
THE NON-CUSTODIAL PARENT'S MAXIMUM ANNUAL  CASH  MEDICAL  SUPPORT  OBLI-
GATION,  WHICH  SHALL  BE EQUAL TO THE LESSER OF THE MONTHLY AMOUNT THAT
WOULD BE REQUIRED AS A  FAMILY  CONTRIBUTION  UNDER  THE  STATE'S  CHILD
HEALTH  INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF
THE PUBLIC HEALTH LAW FOR THE CHILD  OR  CHILDREN  IF  THEY  WERE  IN  A
TWO-PARENT  HOUSEHOLD  WITH  INCOME  EQUAL TO THE COMBINED INCOME OF THE
NON-CUSTODIAL AND CUSTODIAL PARENTS TIMES TWELVE MONTHS OR THE NUMBER OF
MONTHS THAT THE CHILD OR CHILDREN  ARE  AUTHORIZED  FOR  FEE-FOR-SERVICE
COVERAGE  DURING ANY YEAR. THE COURT SHALL SEPARATELY STATE IN THE ORDER
THE NON-CUSTODIAL PARENT'S MAXIMUM ANNUAL  CASH  MEDICAL  SUPPORT  OBLI-
GATION AND, UPON PROOF TO THE COURT THAT THE NON-CUSTODIAL PARENT, AFTER
NOTICE  OF  THE  AMOUNT  DUE,  HAS  FAILED  TO PAY THE PUBLIC ENTITY FOR
INCURRED HEALTH CARE EXPENSES, THE COURT SHALL ORDER  THE  NON-CUSTODIAL
PARENT TO PAY SUCH INCURRED HEALTH CARE EXPENSES UP TO THE MAXIMUM ANNU-
AL  CASH  MEDICAL  SUPPORT  OBLIGATION.  SUCH  AMOUNTS  SHALL BE SUPPORT
ARREARS/PAST DUE SUPPORT  AND  SHALL  BE  SUBJECT  TO  ANY  REMEDIES  AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
THE  TOTAL ANNUAL AMOUNT THAT THE NON-CUSTODIAL PARENT IS ORDERED TO PAY
UNDER THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT  OF  HIS  OR  HER  GROSS

S. 4214--A                          5

INCOME  OR  THE DIFFERENCE BETWEEN THE NON-CUSTODIAL PARENT'S INCOME AND
THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (C)  THE COURT SHALL ORDER CASH MEDICAL SUPPORT TO BE PAID BY THE NON-
CUSTODIAL PARENT FOR HEALTH CARE EXPENSES OF THE CHILD OR CHILDREN  PAID
BY  THE  MEDICAL ASSISTANCE PROGRAM PRIOR TO THE ISSUANCE OF THE COURT'S
ORDER. THE AMOUNT OF SUCH SUPPORT SHALL BE CALCULATED AS PROVIDED  UNDER
ITEM  (A)  OR  (B)  OF  THIS  CLAUSE,  PROVIDED THAT THE AMOUNT THAT THE
NON-CUSTODIAL PARENT IS ORDERED TO PAY UNDER THIS ITEM SHALL NOT  EXCEED
FIVE  PERCENT  OF  HIS OR HER GROSS INCOME OR THE DIFFERENCE BETWEEN THE
NON-CUSTODIAL PARENT'S INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS
LESS, FOR THE YEAR WHEN THE EXPENSE WAS INCURRED. SUCH AMOUNTS SHALL  BE
SUPPORT ARREARS/PAST DUE SUPPORT AND SHALL BE SUBJECT TO ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
  (IV)  WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPH ONE AND
CLAUSES (I) AND (II) OF SUBPARAGRAPH TWO OF PARAGRAPH (C) OF SUBDIVISION
ONE OF THIS SECTION ARE DETERMINED BY THE COURT TO BE  UNAVAILABLE,  AND
THE  CHILD  OR  CHILDREN  ARE DETERMINED ELIGIBLE FOR COVERAGE UNDER THE
STATE'S CHILD HEALTH INSURANCE PLAN PURSUANT TO TITLE ONE-A  OF  ARTICLE
TWENTY-FIVE  OF  THE  PUBLIC  HEALTH  LAW,  THE COURT SHALL PRORATE EACH
PARENT'S SHARE OF THE COST OF THE  FAMILY  CONTRIBUTION  REQUIRED  UNDER
SUCH CHILD HEALTH INSURANCE PLAN IN THE SAME PROPORTION AS EACH PARENT'S
INCOME  IS  TO THE COMBINED PARENTAL INCOME, AND STATE THE AMOUNT OF THE
NON-CUSTODIAL PARENT'S SHARE IN THE ORDER.  THE  TOTAL  AMOUNT  OF  CASH
MEDICAL  SUPPORT  THAT  THE NON-CUSTODIAL PARENT IS ORDERED TO PAY UNDER
THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER GROSS INCOME, OR
THE  DIFFERENCE  BETWEEN  THE  NON-CUSTODIAL  PARENT'S  INCOME  AND  THE
SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (V)  IN  ADDITION  TO THE AMOUNTS ORDERED UNDER CLAUSE (II), (III), OR
(IV), THE COURT SHALL PRO RATE EACH PARENT'S SHARE OF REASONABLE  HEALTH
CARE  EXPENSES  NOT REIMBURSED OR PAID BY INSURANCE, THE MEDICAL ASSIST-
ANCE PROGRAM ESTABLISHED PURSUANT TO TITLE ELEVEN OF ARTICLE FIVE OF THE
SOCIAL SERVICES LAW, OR THE STATE'S CHILD HEALTH INSURANCE PLAN PURSUANT
TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW,  IN  THE
SAME  PROPORTION  AS  EACH  PARENT'S  INCOME IS TO THE COMBINED PARENTAL
INCOME, AND STATE THE NON-CUSTODIAL PARENT'S SHARE AS  A  PERCENTAGE  IN
THE ORDER. THE NON-CUSTODIAL PARENT'S PRO RATA SHARE OF SUCH HEALTH CARE
EXPENSES  DETERMINED  BY  THE COURT TO BE DUE AND OWING SHALL BE SUPPORT
ARREARS/PAST DUE SUPPORT AND SHALL BE SUBJECT TO ANY  REMEDIES  PROVIDED
BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT. IN ADDI-
TION,  THE  COURT  MAY  DIRECT  THAT THE NON-CUSTODIAL PARENT'S PRO RATA
SHARE OF SUCH HEALTH CARE EXPENSES BE PAID IN ONE  SUM  OR  IN  PERIODIC
SUMS, INCLUDING DIRECT PAYMENT TO THE HEALTH CARE PROVIDER.
  (VI)  UPON PROOF BY EITHER PARTY THAT CASH MEDICAL SUPPORT PURSUANT TO
CLAUSE (II), (III), (IV), OR (V) OF THIS SUBPARAGRAPH WOULD BE UNJUST OR
INAPPROPRIATE PURSUANT TO PARAGRAPH (F) OF THIS SUBDIVISION,  THE  COURT
SHALL:
  (A)  ORDER  THE PARTIES TO PAY CASH MEDICAL SUPPORT AS THE COURT FINDS
JUST AND APPROPRIATE, CONSIDERING THE BEST INTERESTS OF THE CHILD; AND
  (B) SET FORTH IN THE ORDER  THE  FACTORS  IT  CONSIDERED,  THE  AMOUNT
CALCULATED  UNDER THIS SUBPARAGRAPH, THE REASON OR REASONS THE COURT DID
NOT ORDER SUCH AMOUNT, AND THE BASIS FOR THE AMOUNT AWARDED.
  S 3. Subdivision (d) of section 416 of the family court act is amended
by adding a new paragraph 3 to read as follows:
  (3) WHEN THE PERSON ON WHOSE BEHALF THE PETITION IS BROUGHT IS A CHILD
IN ACCORDANCE WITH SUBDIVISION (E) OF  THIS  SECTION,  HEALTH  INSURANCE
BENEFITS  SHALL BE CONSIDERED "REASONABLE IN COST" IF THE COST OF HEALTH

S. 4214--A                          6

INSURANCE BENEFITS DOES NOT EXCEED FIVE PERCENT OF THE COMBINED PARENTAL
GROSS INCOME.  THE COST OF HEALTH INSURANCE BENEFITS SHALL REFER TO  THE
COST  OF  THE PREMIUM AND DEDUCTIBLE ATTRIBUTABLE TO ADDING THE CHILD OR
CHILDREN  TO  EXISTING COVERAGE OR THE DIFFERENCE BETWEEN SUCH COSTS FOR
SELF-ONLY AND FAMILY COVERAGE. PROVIDED, HOWEVER, THE  PRESUMPTION  THAT
THE  HEALTH  INSURANCE  BENEFITS  ARE REASONABLE IN COST MAY BE REBUTTED
UPON A FINDING THAT THE COST IS UNJUST OR  INAPPROPRIATE  WHICH  FINDING
SHALL BE BASED ON THE CIRCUMSTANCES OF THE CASE, THE COST AND COMPREHEN-
SIVENESS  OF  THE HEALTH INSURANCE BENEFITS FOR WHICH THE CHILD OR CHIL-
DREN MAY OTHERWISE BE ELIGIBLE, AND THE BEST INTERESTS OF THE  CHILD  OR
CHILDREN.   IN NO INSTANCE SHALL HEALTH INSURANCE BENEFITS BE CONSIDERED
"REASONABLE IN COST" IF A PARENT'S SHARE OF THE COST OF  EXTENDING  SUCH
COVERAGE  WOULD  REDUCE THE INCOME OF THAT PARENT BELOW THE SELF-SUPPORT
RESERVE. HEALTH INSURANCE BENEFITS ARE "REASONABLY  ACCESSIBLE"  IF  THE
CHILD  LIVES  WITHIN  THE  GEOGRAPHIC  AREA COVERED BY THE PLAN OR LIVES
WITHIN THIRTY MINUTES OR THIRTY MILES OF TRAVEL TIME  FROM  THE  CHILD'S
RESIDENCE  TO  THE  SERVICES COVERED BY THE HEALTH INSURANCE BENEFITS OR
THROUGH BENEFITS PROVIDED UNDER A RECIPROCAL AGREEMENT; PROVIDED, HOWEV-
ER, THIS PRESUMPTION MAY BE REBUTTED FOR GOOD CAUSE SHOWN INCLUDING, BUT
NOT LIMITED TO, THE SPECIAL HEALTH NEEDS OF THE CHILD.  THE COURT  SHALL
SET FORTH SUCH FINDING AND THE REASONS THEREFOR IN THE ORDER OF SUPPORT.
  S  4.  Paragraph  (b)  of subdivision 1 of section 240 of the domestic
relations law is amended by adding a  new  subparagraph  3  to  read  as
follows:
  (3) WHEN THE PERSON ON WHOSE BEHALF THE PETITION IS BROUGHT IS A CHILD
IN  ACCORDANCE  WITH PARAGRAPH (C) OF THIS SUBDIVISION, HEALTH INSURANCE
BENEFITS SHALL BE CONSIDERED "REASONABLE IN COST" IF THE COST OF  HEALTH
INSURANCE BENEFITS DOES NOT EXCEED FIVE PERCENT OF THE COMBINED PARENTAL
GROSS  INCOME.  THE COST OF HEALTH INSURANCE BENEFITS SHALL REFER TO THE
COST OF THE PREMIUM AND DEDUCTIBLE ATTRIBUTABLE TO ADDING THE  CHILD  OR
CHILDREN  TO  EXISTING COVERAGE OR THE DIFFERENCE BETWEEN SUCH COSTS FOR
SELF-ONLY AND FAMILY COVERAGE. PROVIDED, HOWEVER, THE  PRESUMPTION  THAT
THE  HEALTH  INSURANCE  BENEFITS  ARE REASONABLE IN COST MAY BE REBUTTED
UPON A FINDING THAT THE COST IS UNJUST OR  INAPPROPRIATE  WHICH  FINDING
SHALL BE BASED ON THE CIRCUMSTANCES OF THE CASE, THE COST AND COMPREHEN-
SIVENESS  OF  THE HEALTH INSURANCE BENEFITS FOR WHICH THE CHILD OR CHIL-
DREN MAY OTHERWISE BE ELIGIBLE, AND THE BEST INTERESTS OF THE  CHILD  OR
CHILDREN.   IN NO INSTANCE SHALL HEALTH INSURANCE BENEFITS BE CONSIDERED
"REASONABLE IN COST" IF A PARENT'S SHARE OF THE COST OF  EXTENDING  SUCH
COVERAGE  WOULD  REDUCE THE INCOME OF THAT PARENT BELOW THE SELF-SUPPORT
RESERVE. HEALTH INSURANCE BENEFITS ARE "REASONABLY  ACCESSIBLE"  IF  THE
CHILD  LIVES  WITHIN  THE  GEOGRAPHIC  AREA COVERED BY THE PLAN OR LIVES
WITHIN THIRTY MINUTES OR THIRTY MILES OF TRAVEL TIME  FROM  THE  CHILD'S
RESIDENCE  TO  THE  SERVICES COVERED BY THE HEALTH INSURANCE BENEFITS OR
THROUGH BENEFITS PROVIDED UNDER A RECIPROCAL AGREEMENT; PROVIDED, HOWEV-
ER, THIS PRESUMPTION MAY BE REBUTTED FOR GOOD CAUSE SHOWN INCLUDING, BUT
NOT LIMITED TO, THE SPECIAL HEALTH NEEDS OF THE CHILD.  THE COURT  SHALL
SET FORTH SUCH FINDING AND THE REASONS THEREFOR IN THE ORDER OF SUPPORT.
  S  5.  Subparagraph (iii) of paragraph 2 of subdivision (e) of section
416 of the family court act, as added by chapter  624  of  the  laws  of
2002, is amended to read as follows:
  (iii)  If  neither parent has available health insurance benefits, the
court shall direct in the order of support  that  the  custodial  parent
apply  for  the  state's  child  health insurance plan pursuant to title
one-A of article twenty-five of the public health law  and  the  medical
assistance  program established pursuant to title eleven of article five

S. 4214--A                          7

of the social services law. [If eligible for such  coverage,  the  court
shall  prorate the cost of any premium or family contribution in accord-
ance with subdivision (f) of this section.]  A  direction  issued  under
this  subdivision shall not limit or alter either parent's obligation to
obtain health insurance benefits at such time as they  become  available
as  required  pursuant  to  subdivision (c) of this section.  NOTHING IN
THIS SUBDIVISION SHALL ALTER OR  LIMIT  THE  AUTHORITY  OF  THE  MEDICAL
ASSISTANCE  PROGRAM TO DETERMINE WHEN IT IS CONSIDERED COST EFFECTIVE TO
REQUIRE A CUSTODIAL PARENT TO ENROLL  A  CHILD  IN  AN  AVAILABLE  GROUP
HEALTH  INSURANCE PLAN PURSUANT TO PARAGRAPHS (B) AND (C) OF SUBDIVISION
ONE OF SECTION THREE HUNDRED SIXTY-SEVEN-A OF THE SOCIAL SERVICES LAW.
  S 6. Clause (iii) of subparagraph 2 of paragraph (c) of subdivision  1
of  section 240 of the domestic relations law, as amended by chapter 624
of the laws of 2002, is amended to read as follows:
  (iii) If neither parent has available health insurance  benefits,  the
court  shall  direct  in  the order of support that the custodial parent
apply for the state's child health  insurance  plan  pursuant  to  title
one-A  of  article  twenty-five of the public health law and the medical
assistance program established pursuant to title eleven of article  five
of  the  social  services law. [If eligible for such coverage, the court
shall prorate the cost of any premium or family contribution in  accord-
ance  with  paragraph (d) of this subdivision.] A direction issued under
this subdivision shall not limit or alter either parent's obligation  to
obtain  health insurance benefits at such time as they become available,
as required pursuant to paragraph (a) of this subdivision.   NOTHING  IN
THIS  SUBDIVISION  SHALL  ALTER  OR  LIMIT  THE AUTHORITY OF THE MEDICAL
ASSISTANCE PROGRAM TO DETERMINE WHEN IT IS CONSIDERED COST EFFECTIVE  TO
REQUIRE  A  CUSTODIAL  PARENT  TO  ENROLL  A CHILD IN AN AVAILABLE GROUP
HEALTH INSURANCE PLAN PURSUANT TO PARAGRAPHS (B) AND (C)  OF SUBDIVISION
ONE OF SECTION THREE HUNDRED SIXTY-SEVEN-A OF THE SOCIAL SERVICES LAW.
  S 7. Subdivision (f) of  section  416  of  the  family  court  act  is
REPEALED and a new subdivision (f) is added to read as follows:
  (F)  THE COST OF PROVIDING HEALTH INSURANCE BENEFITS OR BENEFITS UNDER
THE STATE'S CHILD  HEALTH  INSURANCE  PLAN  OR  THE  MEDICAL  ASSISTANCE
PROGRAM,  PURSUANT  TO  SUBDIVISION (E) OF THIS SECTION, SHALL BE DEEMED
CASH MEDICAL SUPPORT, AND THE COURT SHALL DETERMINE  THE  OBLIGATION  OF
EITHER  OR  BOTH  PARENTS  TO CONTRIBUTE TO THE COST THEREOF PURSUANT TO
SUBPARAGRAPH FIVE OF PARAGRAPH (C) OF SUBDIVISION ONE  OF  SECTION  FOUR
HUNDRED THIRTEEN OF THIS PART.
  S  8.  Paragraph  (d)  of subdivision 1 of section 240 of the domestic
relations law is REPEALED and a new paragraph (d) is added  to  read  as
follows:
  (D)  THE COST OF PROVIDING HEALTH INSURANCE BENEFITS OR BENEFITS UNDER
THE STATE'S CHILD  HEALTH  INSURANCE  PLAN  OR  THE  MEDICAL  ASSISTANCE
PROGRAM,  PURSUANT TO PARAGRAPH (C) OF THIS SUBDIVISION, SHALL BE DEEMED
CASH MEDICAL SUPPORT, AND THE COURT SHALL DETERMINE  THE  OBLIGATION  OF
EITHER  OR  BOTH  PARENTS  TO CONTRIBUTE TO THE COST THEREOF PURSUANT TO
SUBPARAGRAPH FIVE OF PARAGRAPH (C) OF SUBDIVISION ONE-B OF THIS SECTION.
  S 9. Section 514 of the family court act, as amended by chapter 81  of
the laws of 1995, is amended to read as follows:
  S  514.  Liability  of father to mother. The father is liable [to pay]
FOR the reasonable expenses of the mother's confinement and recovery and
such reasonable expenses in connection with her pregnancy as  DETERMINED
BY  the  court  [in  its discretion may deem proper]; provided, however,
where the mother's confinement, recovery and expenses in connection with
her pregnancy were paid under the  medical  assistance  program  on  the

S. 4214--A                          8

mother's  behalf,  the  father  may  be  liable  to  the social services
district furnishing such medical assistance and to the state  department
of  [social services] HEALTH for [the full amount of] medical assistance
so  expended[,  as  the  court in its discretion may deem proper].  SUCH
EXPENSES, INCLUDING SUCH EXPENSES PAID BY THE MEDICAL ASSISTANCE PROGRAM
ON THE MOTHER'S BEHALF, SHALL BE DEEMED CASH  MEDICAL  SUPPORT  AND  THE
COURT SHALL DETERMINE THE OBLIGATION OF THE PARTIES TO CONTRIBUTE TO THE
COST  THEREOF PURSUANT TO SUBPARAGRAPH FIVE OF PARAGRAPH (C) OF SUBDIVI-
SION ONE OF SECTION FOUR HUNDRED THIRTEEN OF THIS ACT.
  S 10. Subdivision 1 of section 545 of the family court act, as amended
by chapter 214 of the laws of 1998, is amended to read as follows:
  1. In a proceeding in which the court has made an order of  filiation,
the  court  shall  direct  the parent or parents possessed of sufficient
means or able to earn such means to pay weekly or at other fixed periods
a fair and reasonable sum according to their  respective  means  as  the
court  may  determine  and apportion for such child's support and educa-
tion, until the child is twenty-one. The order shall be effective as  of
the  earlier  of  the date of the application for an order of filiation,
or, if the children for whom support is sought are in receipt of  public
assistance,  the  date for which their eligibility for public assistance
was effective. Any retroactive amount of child support shall be  support
arrears/past-due  support  and shall be paid in one sum or periodic sums
as the court shall direct, taking into account any amount  of  temporary
support which has been paid. In addition, such retroactive child support
shall  be  enforceable  in any manner provided by law including, but not
limited to, an execution for support enforcement pursuant to subdivision
(b) of section fifty-two hundred forty-one of the civil practice law and
rules.  The court shall direct such parent to make his or her  residence
known  at all times should he or she move from the address last known to
the court by reporting such change to the support collection unit desig-
nated by the appropriate  social  services  district.  The  order  shall
contain  the social security numbers of the named parents. The order may
also direct each parent to pay an amount as the court may determine  and
apportion  for the support of the child prior to the making of the order
of filiation, and may direct each parent to pay an amount as  the  court
may  determine and apportion for [(i)] the funeral expenses if the child
has died[; (ii) the]. THE necessary expenses  incurred  by  or  for  the
mother  in  connection  with her confinement and recovery[;] and [(iii)]
such expenses in connection with the pregnancy of  the  mother  [as  the
court  may  deem  proper]  SHALL BE DEEMED CASH MEDICAL SUPPORT, AND THE
COURT SHALL DETERMINE THE  OBLIGATION  OF  EITHER  OR  BOTH  PARENTS  TO
CONTRIBUTE  TO  THE  COST THEREOF PURSUANT TO SUBPARAGRAPH FIVE OF PARA-
GRAPH (C) OF SUBDIVISION ONE OF SECTION FOUR HUNDRED  THIRTEEN  OF  THIS
ACT.   In addition, the court shall make provisions for health insurance
benefits in accordance with the requirements  of  section  four  hundred
sixteen of this act.
  S  11.  Subparagraph  (i) of paragraph 2 of subdivision (b) of section
5241 of the civil practice law and rules, as amended by chapter  533  of
the laws of 1999, is amended to read as follows:
  (i)  Where  the  court  orders  the debtor to provide health insurance
benefits for specified dependents,  an  execution  for  medical  support
enforcement may, except as provided for herein, be issued by the support
collection  unit,  or by the sheriff, the clerk of court or the attorney
for the creditor as an officer of the  court;  provided,  however,  that
when  the  court  issues an order of child support or combined child and
spousal support on behalf of persons other  than  those  in  receipt  of

S. 4214--A                          9

public  assistance  or  in  receipt  of services pursuant to section one
hundred eleven-g of the social  services  law,  such  medical  execution
shall be in the form of a separate qualified medical child support order
as  provided by subdivision [(f)] (J) of section four hundred sixteen of
the family court act and paragraph  [(f)]  (H)  of  subdivision  one  of
section  two hundred forty of the domestic relations law. Such execution
for medical support  enforcement  may  require  the  debtor's  employer,
organization or group health plan administrator to purchase on behalf of
the  debtor  and the debtor's dependents such available health insurance
benefits. Such execution shall  direct  the  employer,  organization  or
group  health  plan  administrator to provide to the dependents for whom
such benefits are required to be provided or such dependents'  custodial
parent  or  legal  guardian  or  social  services  district on behalf of
persons applying for or in receipt of public assistance any  identifica-
tion  cards  and  benefit  claim forms and to withhold from the debtor's
income the employee's share of the cost of such health  insurance  bene-
fits,  and to provide written confirmation of such enrollment indicating
the date such benefits were or become available or  that  such  benefits
are  not  available  and  the  reasons  therefor  to  the  issuer of the
execution. An  execution  for  medical  support  enforcement  shall  not
require  a debtor's employer, organization or group health plan adminis-
trator to purchase or  otherwise  acquire  health  insurance  or  health
insurance  benefits  that would not otherwise be available to the debtor
by reason of his or her employment or membership. Nothing  herein  shall
be  deemed  to  obligate or otherwise hold any employer, organization or
group health plan administrator responsible for an option  exercised  by
the  debtor  in  selecting  medical insurance coverage by an employee or
member.
  S 12. Subdivision (h) of section 5241 of the civil  practice  law  and
rules, as amended by chapter 398 of the laws of 1997, is amended to read
as follows:
  (h)  Priority.  A levy pursuant to this section or an income deduction
order pursuant to section 5242 of this chapter shall take priority  over
any other assignment, levy or process. If an employer or income payor is
served with more than one execution pursuant to this section, or with an
execution pursuant to this section and also an order pursuant to section
5242 of this chapter, and if the combined total amount of the deductions
to  be  withheld exceeds the limits set forth in subdivision (g) of this
section, the employer or income payor shall withhold the maximum  amount
permitted thereby and pay to each creditor that proportion thereof which
such  creditor's  claim  bears  to  the  combined  total. Any additional
deduction authorized by subdivision (g) of this section to be applied to
the reduction of arrears shall be applied to such arrears in  proportion
to  the  amount  of  arrears due to each creditor. Deductions to satisfy
CURRENT  support  obligations[,  including  any  additional   deductions
authorized by subdivision (g) of this section,] shall have priority over
deductions  for  the  debtor's  share of health insurance premiums WHICH
SHALL HAVE PRIORITY OVER ANY ADDITIONAL DEDUCTION AUTHORIZED BY SUBDIVI-
SION (G) OF THIS SECTION.
  S 13. This act shall take effect on the ninetieth day after  it  shall
have  become  a  law  and  shall apply to any proceeding to establish or
modify a child support obligation, including  a  medical  support  obli-
gation, commenced on or after such date.

2009-S4214B (ACTIVE) - Details

Law Section:: Family Court Act
Laws Affected:: Rpld & add §413 sub 1 ¶(c) sub¶ 5, §416 sub (f), amd §§416, 514 & 545, Fam Ct Act; rpld & add §240 sub 1-b ¶(c) sub¶ 5, sub 1 ¶(d), amd §240, Dom Rel L; amd §5241, CPLR

2009-S4214B (ACTIVE) - Summary

Establishes definitions for "cash medical support", "reasonable in cost" and "reasonably accessible"; amends the priority for deductions via an income execution.

2009-S4214B (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S4214B

 TITLE OF BILL :
An act to amend the family court act and the domestic relations law,
in relation to establishing definitions for "cash medical support",
and when health insurance benefits are "reasonable in cost" and
"reasonably accessible"; to amend the civil practice law and rules, in
relation to amending the priority for deductions via an income
execution; and to repeal certain provisions of the family court act
and the domestic relations law relating thereto


 PURPOSE OF BILL :
This bill would enact federal mandates set forth in the final medical
support regulations for the child support enforcement program,
released by the federal Department of Health and Human Services on
July 21, 2008. The federal regulations require each state to define
when private health insurance benefits, an element of support, are
"reasonable in cost" and when such health insurance shall be
considered "reasonably accessible."

 SUMMARY OF PROVISIONS :
Sections 1 and 2 of the bill would amend section 413 of the Family
Court Act (FCA) and section 240 of the Domestic Relations Law (DRL),
respectively, to require the court to determine the availability of
private health insurance benefits, define the term "cash medical

support," and provide an income-based numeric standard for determining
when cash medical support should be ordered and the amount of each
parent's contribution. For children enrolled in the State Child Health
Insurance Program (SCHT), the portion of cash medical support
attributable to public coverage is the pro rata share of the family
contribution under the State's child health insurance plan. For
children enrolled in the Medical Assistance (MA) program, the
non-custodial parent's obligation for the portion of cash medical
support attributable to public benefits is the lesser of (1) the
amount that would be required under SCHIP using the combined income of
the parents as if the child(ren) were in a two-parent household; or,
(2) the actual amount expended by the MA program. For children
enrolled in either program, the total cash medical support obligation
for costs attributable to public coverage or benefits shall not exceed
5% of the non-custodial parent's income or reduce the parent's income
below the self-support reserve.

Sections 3 and 4 of the bill would amend section 416 of the FCA and
section 240 of the DRL, respectively, to define the terms "reasonable
in cost" and "reasonably accessible," to aid the court in determining
whether the private health insurance benefits are available to a
child.

Sections 5 and 6 of the bill would amend section 416(e)(2)(iii) of the
FCA and section 240(1)(c)(2)(iii) of the DRL. These sections provider
that when private health insurance benefits are unavailable, the
custodial parent must be directed to apply for SCHIP or MA.  The
current language allowing the court to apportion the cost of any
premium, family contribution, or health expense associated with
participation in such plan or program is deleted.

Sections 7 and 8 would amend section 416(f) of the FCA and section
240(1)(d) of the DRL.  These sections currently provide for the
proration of costs between the parties where private health insurance
is ordered. The subdivisions are amended to state that the cost of
private health insurance, or the cost of any premium, family
contribution, or health expense incurred as a result of enrollment in
SCHIP or the MA program shall be deeded cash medical support and each
parent's contribution will be determined under the amended provisions
in sections 1 and 2 of this bill.
Sections 9 and 10 of the bill would amend section 514 and 545 of the
FCA, respectively, to provide that the necessary expenses incurred by
or for the mother in connection with her pregnancy, confinement and
recovery shall be determined deemed a cash medical support obligation
and the court shall determine the obligation of either or both to
contribute to the cost pursuant to section 413 of the FCA, the Child
Support Standards Act.

Section 11 of the bill would amend section 524(b)(2)(i) of the Civil
Practice Law and Rules (CPLR) to correct a statutory reference.

Section 12 of the bill would amend section 5241(h) of the CPLR to
revise the priority of deductions made by an employer or income payor
in response to an income execution, medical support execution or
income deduction order.  Under this bill, the employer will first
deduct the amount due for current child support obligations, then the
cost of health insurance premiums, then the additional amount to
reduce support arrears.

Section 13 of the bill would provide that the amendments would be
effective on the ninetieth day after it shall become law and apply to
any proceeding to establish or modify a child support obligation,
including a medical support obligation commenced on or after that
date.

 EXISTING LAW :
Various sections of the FCA, DRL and the Social Services Law (SSL)
contain provisions concerning the obligation of parents to support
their children and provide procedures for the establishment of
paternity and the establishment, enforcement and modification of child
support obligations, including the cost of health insurance coverage
and other health care expenses.  Section 5241 of the CPLR contains the
procedure associated with utilizing income executions and medical
support executions for support enforcement.

 JUSTIFICATION :
The provision of health insurance benefits and medical support is an
important component of child support. This bill would allow New York
to comply with the federal final rules (45 CFR 302.56; 303.31)
pertaining to medical support which requires states to define the
terms "reasonable in cost" and "reasonably accessible" in relation to
the availability of private health insurance, and also the federal
mandate to set a reasonable income-based numeric standard for
determining when cash medical support should be ordered.

Under federal regulations, private health insurance is considered
"available" when it is reasonable in cost and reasonably accessible as
those terms are defined by a state. In the event that private health
insurance is not "available", the regulations mandate that states seek
an order for "cash medical support" until such time as private health
insurance becomes available.  Additionally, the final medical support
regulations allow states to define when it is appropriate to seek cash
medical support in addition to private health insurance benefits.

This bill would define "cash medical support" under the child support
standards as the amount to be paid for the cost of health insurance
provided by a public entity or by a parent through an employer or
organization, and/or for other health care costs not covered by
insurance. It sets out the method of apportioning the cost of the
different types of cash medical support, such as private health
insurance premiums, benefits provided by the SCHIP and the MA program,
as well as health care expenses not covered by health insurance. The
bill also limits the establishment of cash medical support obligations
in support orders so that the non-custodial parent's income will not
be reduced below the self-support reserve (135% of the federal poverty
income guidelines for a single person).
This bill would adopt the federal option for the State definition of
cash medical support and provide a method for the court to determine
the parties obligation to provide each of the three types of cash
medical support. First if private health insurance benefits are
determined by a court to be "available" (i.e., the cost of securing
such benefits is 5% or less of the parties' gross income), the court
must order the non-custodial parent to pay his or her pro rata share
of the health insurance premium.  The primary goal of these provisions
is to ensure that private health health insurance is utilized when
available at reasonable cost. The use of private health insurance may
reduce the cost of health care for the child expended by the parents
and the public.

Second, if the child covered by private health insurance incurs
additional unreimbursed health care expenses, the court shall order
the non-custodial parent to pay his or her pro rata share of the
reasonable cash medical support expenses.  Orders requiring the
non-custodial parent to pay his or her share of unreimbursed health
care expenses are currently a mandatory provision under the Child
Support Standards Act. The bill continues this obligation.  When
combined with the cost to the parent for private health insurance or
public coverage, the total payment ordered by the court for cash
medical support may not cause his or her income to fall below the
self-support reserve.

Third, where private health insurance benefits are determined by the
court not to be "available," the custodial parent will be ordered, in
accordance with current law, to apply for SCHIP or MA. If the child is
determined eligible for SCRIP, the portion of cash medical support
associated with public coverage or benefits is the prorated share of
the family contribution under SCHIP. For children, enrolled in MA
(regardless of whether it is managed care or fee-for-service), the
non-custodial parent's obligation towards the portion of cash medical
support for public coverage or benefits is the lesser of the amount
that would be required under SCHIP using the combined income of the
parents as if the chil(dren) were in a two parent household, or the
actual amount expended by the MA program.  In managed care cases, the
court will order a monthly obligation for the portion of cash medical
support associated with public coverage. In fee-for-service cases, for
the portion of cash medical support associated with public coverage,
the court will set forth in the order the maximum annual cash support
obligation based on the amount that would be required under SCHIP in a
two-parent household.

For children enrolled in either program, in no case shall the cash
medical support obligation for public coverage or benefits exceed 5%
of the non-custodial parent's gross income, or the difference between
the non-custodial parent's income and the self-support reserve,
whichever is less.

The bill would also define two terms that are considered by courts in
determining whether private health insurance benefits are available to
a child.  Private health  insurance benefits must be "reasonable in
cost" and "reasonably accessible" in order to be deemed available.

The first term, "reasonable in cost" is defined in this bill to mean
that the cost of premiums and deductibles for private health insurance
attributable to the child(ren) does not exceed five percent of the
combined parental gross income. However, no benefits will be
considered "reasonable in cost" if the cost to a parent of extending
coverage to the child(ren) would reduce the income of that parent
below the self support reserve. In addition, upon a finding of the
court that the cost borne by a parent is unjust or inappropriate, the
presumption of cost reasonableness may be rebutted.


Pursuant to the federal regulations, where the child(ren) will be
added to existing benefits, the "cost" to be considered in determining
reasonableness is the difference between self-only (individual)
benefits and health insurance benefits which extend to all the
children who are the subject of the order.  This would include
determining the portion of any deductible attributable to the
child(ren) which should be considered for purposes of this analysis.
Only the incremental increase in the deductible associated with adding
the child(ren) to existing coverage or, the incremental difference
between the deductible for self-only coverage and coverage extending
to the child, is to be considered.

"Reasonably accessible is defined to mean that the child lives within
the geographic area covered by the plan or lives within thirty minutes
or thirty miles of services covered by the health insurance benefits
or through benefits provided under a reciprocal agreement.  The
presumption of accessibility may be rebutted for good cause shown
which may include, but is not limited to, a consideration of the
special health needs of the subject child.

In addition to complying with the federal mandate, these provisions
will improve child support orders.  Currently, the courts do not have
a standard definition of reasonable cost. Different courts apply
different standards, and even calculate the cost of health insurance
differently. Greater consistency in determining whether health
insurance is available - that is, reasonable in cost and reasonably
accessible - is anticipated as a result of this bill.  In addition,
the court is given flexibility to address the parties' individual
circumstances and set an order that is just and appropriate.

This bill would also clarify that the cost of private health insurance
premiums or any premium, family contribution, or health expense
associated with enrollment of a child in SCRIP or MA is cash medical
support.  The proposed amendments refer the court to the Child Support
Standards Act to calculate the amount of each parties' contribution to
the cost of these expenses.

The bill would further clarify that the necessary expenses incurred by
or for the mother in connection with her pregnancy, confinement and
recovery are a cash medical support obligation to the father.  Where
these expenses were paid under the MA program on the mother's behalf,
the father's liability to the social services district and the State
will be subject to the same cap and low income protections as cash
medical support for other MA expenses.

Finally, the bill amends the priorities for income withholding by an
employer or other income payor.  Consistent with the goal of providing
private health insurance benefits whenever possible, deductions to
satisfy support obligations will have the following priority: (1)
current support obligations; (2) health insurance premiums; (3)
arrears.

 LEGISLATIVE HISTORY :
In the 2008 Legislative Session, provisions similar to sections three
and four of this bill were part of S.8340, but S.8340 was not reported
from the Senate Rules Committee.

 FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS :
Failure to pass this bill will put the State out of IV-D Plan
compliance and subject the State to elimination of federal
reimbursement.

 EFFECTIVE DATE :
The bill would take effect on the ninetieth day after it shall become
law and apply to any proceeding to establish or modify a child support
obligation including a medical support obligation, commenced on or
after that date.

2009-S4214B (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4214--B

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             April 17, 2009
                               ___________

Introduced by Sen. SAMPSON -- (at request of the Office of Temporary and
  Disability  Assistance)  --  read  twice and ordered printed, and when
  printed to be committed to the  Committee  on  Judiciary  --  reported
  favorably  from  said  committee  and  committed  to  the Committee on
  Finance -- committee discharged, bill amended,  ordered  reprinted  as
  amended  and  recommitted  to  said committee -- committee discharged,
  bill amended, ordered reprinted as amended  and  recommitted  to  said
  committee

AN  ACT to amend the family court act and the domestic relations law, in
  relation to establishing definitions for "cash medical  support",  and
  when  health  insurance benefits are "reasonable in cost" and "reason-
  ably accessible"; to amend  the  civil  practice  law  and  rules,  in
  relation  to  amending  the  priority  for  deductions  via  an income
  execution; and to repeal certain provisions of the  family  court  act
  and the domestic relations law relating thereto

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subparagraph 5 of paragraph (c) of subdivision 1 of section
413 of the family court act is REPEALED and  a  new  subparagraph  5  is
added to read as follows:
  (5)  THE  COURT  SHALL  DETERMINE  THE  PARTIES' OBLIGATION TO PROVIDE
HEALTH INSURANCE BENEFITS PURSUANT TO SECTION FOUR  HUNDRED  SIXTEEN  OF
THIS PART AND TO PAY CASH MEDICAL SUPPORT AS PROVIDED UNDER THIS SUBPAR-
AGRAPH.
  (I)  "CASH  MEDICAL SUPPORT" MEANS AN AMOUNT ORDERED TO BE PAID TOWARD
THE COST OF HEALTH INSURANCE PROVIDED BY A PUBLIC ENTITY OR BY A  PARENT
THROUGH  AN EMPLOYER OR ORGANIZATION, INCLUDING SUCH EMPLOYERS OR ORGAN-
IZATIONS WHICH ARE SELF  INSURED,  OR  THROUGH  OTHER  AVAILABLE  HEALTH
INSURANCE  OR  HEALTH  CARE COVERAGE PLANS, AND/OR FOR OTHER HEALTH CARE
EXPENSES NOT COVERED BY INSURANCE.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07704-09-9

S. 4214--B                          2

  (II) WHERE HEALTH INSURANCE BENEFITS PURSUANT  TO  PARAGRAPH  ONE  AND
SUBPARAGRAPHS  (I)  AND  (II)  OF  PARAGRAPH  TWO  OF SUBDIVISION (E) OF
SECTION FOUR HUNDRED SIXTEEN OF THIS PART ARE DETERMINED BY THE COURT TO
BE AVAILABLE, THE COST OF PROVIDING HEALTH INSURANCE BENEFITS  SHALL  BE
PRORATED  BETWEEN  THE  PARTIES  IN THE SAME PROPORTION AS EACH PARENT'S
INCOME IS TO THE COMBINED PARENTAL INCOME. IF THE  CUSTODIAL  PARENT  IS
ORDERED  TO  PROVIDE  SUCH BENEFITS, THE NON-CUSTODIAL PARENT'S PRO RATA
SHARE OF SUCH COSTS SHALL BE ADDED TO THE BASIC SUPPORT  OBLIGATION.  IF
THE NON-CUSTODIAL PARENT IS ORDERED TO PROVIDE SUCH BENEFITS, THE CUSTO-
DIAL  PARENT'S  PRO  RATA SHARE OF SUCH COSTS SHALL BE DEDUCTED FROM THE
BASIC SUPPORT OBLIGATION.
  (III) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO  PARAGRAPH  ONE  AND
SUBPARAGRAPHS  (I)  AND  (II)  OF  PARAGRAPH  TWO  OF SUBDIVISION (E) OF
SECTION FOUR HUNDRED SIXTEEN OF THIS PART ARE DETERMINED BY THE COURT TO
BE UNAVAILABLE, IF THE CHILD OR CHILDREN  ARE  DETERMINED  ELIGIBLE  FOR
COVERAGE  UNDER  THE  MEDICAL ASSISTANCE PROGRAM ESTABLISHED PURSUANT TO
TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW, THE COURT SHALL
ORDER THE NON-CUSTODIAL PARENT TO PAY CASH MEDICAL SUPPORT AS FOLLOWS:
  (A) IN THE CASE OF A CHILD OR CHILDREN  AUTHORIZED  FOR  MANAGED  CARE
COVERAGE  UNDER THE MEDICAL ASSISTANCE PROGRAM, THE LESSER OF THE AMOUNT
THAT WOULD BE REQUIRED AS A FAMILY CONTRIBUTION UNDER THE STATE'S  CHILD
HEALTH  INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF
THE PUBLIC HEALTH LAW FOR THE CHILD  OR  CHILDREN  IF  THEY  WERE  IN  A
TWO-PARENT  HOUSEHOLD  WITH  INCOME  EQUAL TO THE COMBINED INCOME OF THE
NON-CUSTODIAL AND CUSTODIAL PARENTS OR THE PREMIUM PAID BY  THE  MEDICAL
ASSISTANCE  PROGRAM  ON  BEHALF  OF THE CHILD OR CHILDREN TO THE MANAGED
CARE PLAN. THE COURT SHALL SEPARATELY STATE THE  NON-CUSTODIAL  PARENT'S
MONTHLY  OBLIGATION.  THE  NON-CUSTODIAL  PARENT'S  CASH MEDICAL SUPPORT
OBLIGATION UNDER THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER
GROSS INCOME, OR  THE  DIFFERENCE  BETWEEN  THE  NON-CUSTODIAL  PARENT'S
INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (B)  IN THE CASE OF A CHILD OR CHILDREN AUTHORIZED FOR FEE-FOR-SERVICE
COVERAGE UNDER THE MEDICAL ASSISTANCE PROGRAM  OTHER  THAN  A  CHILD  OR
CHILDREN DESCRIBED IN ITEM (A) OF THIS CLAUSE, THE COURT SHALL DETERMINE
THE  NON-CUSTODIAL  PARENT'S  MAXIMUM  ANNUAL CASH MEDICAL SUPPORT OBLI-
GATION, WHICH SHALL BE EQUAL TO THE LESSER OF THE  MONTHLY  AMOUNT  THAT
WOULD  BE  REQUIRED  AS  A  FAMILY  CONTRIBUTION UNDER THE STATE'S CHILD
HEALTH INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE  OF
THE  PUBLIC  HEALTH  LAW  FOR  THE  CHILD  OR CHILDREN IF THEY WERE IN A
TWO-PARENT HOUSEHOLD WITH INCOME EQUAL TO THE  COMBINED  INCOME  OF  THE
NON-CUSTODIAL AND CUSTODIAL PARENTS TIMES TWELVE MONTHS OR THE NUMBER OF
MONTHS  THAT  THE  CHILD  OR CHILDREN ARE AUTHORIZED FOR FEE-FOR-SERVICE
COVERAGE DURING ANY YEAR. THE COURT SHALL SEPARATELY STATE IN THE  ORDER
THE  NON-CUSTODIAL  PARENT'S  MAXIMUM  ANNUAL CASH MEDICAL SUPPORT OBLI-
GATION AND, UPON PROOF TO THE COURT THAT THE NON-CUSTODIAL PARENT, AFTER
NOTICE OF THE AMOUNT DUE, HAS  FAILED  TO  PAY  THE  PUBLIC  ENTITY  FOR
INCURRED  HEALTH  CARE EXPENSES, THE COURT SHALL ORDER THE NON-CUSTODIAL
PARENT TO PAY SUCH INCURRED HEALTH CARE EXPENSES UP TO THE MAXIMUM ANNU-
AL CASH MEDICAL  SUPPORT  OBLIGATION.  SUCH  AMOUNTS  SHALL  BE  SUPPORT
ARREARS/PAST  DUE  SUPPORT  AND  SHALL  BE  SUBJECT  TO  ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
THE TOTAL ANNUAL AMOUNT THAT THE NON-CUSTODIAL PARENT IS ORDERED TO  PAY
UNDER  THIS  CLAUSE  SHALL  NOT  EXCEED FIVE PERCENT OF HIS OR HER GROSS
INCOME OR THE DIFFERENCE BETWEEN THE NON-CUSTODIAL PARENT'S  INCOME  AND
THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.

S. 4214--B                          3

  (C)  THE COURT SHALL ORDER CASH MEDICAL SUPPORT TO BE PAID BY THE NON-
CUSTODIAL PARENT FOR HEALTH CARE EXPENSES OF THE CHILD OR CHILDREN  PAID
BY  THE  MEDICAL ASSISTANCE PROGRAM PRIOR TO THE ISSUANCE OF THE COURT'S
ORDER. THE AMOUNT OF SUCH SUPPORT SHALL BE CALCULATED AS PROVIDED  UNDER
ITEM  (A)  OR  (B)  OF  THIS  CLAUSE,  PROVIDED THAT THE AMOUNT THAT THE
NON-CUSTODIAL PARENT IS ORDERED TO PAY UNDER THIS ITEM SHALL NOT  EXCEED
FIVE  PERCENT  OF  HIS OR HER GROSS INCOME OR THE DIFFERENCE BETWEEN THE
NON-CUSTODIAL PARENT'S INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS
LESS, FOR THE YEAR WHEN THE EXPENSE WAS INCURRED. SUCH AMOUNTS SHALL  BE
SUPPORT ARREARS/PAST DUE SUPPORT AND SHALL BE SUBJECT TO ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
  (IV)  WHERE  HEALTH  INSURANCE  BENEFITS PURSUANT TO PARAGRAPH ONE AND
SUBPARAGRAPHS (I) AND (II)  OF  PARAGRAPH  TWO  OF  SUBDIVISION  (E)  OF
SECTION FOUR HUNDRED SIXTEEN OF THIS PART ARE DETERMINED BY THE COURT TO
BE  UNAVAILABLE,  AND  THE CHILD OR CHILDREN ARE DETERMINED ELIGIBLE FOR
COVERAGE UNDER THE STATE'S CHILD HEALTH INSURANCE PLAN PURSUANT TO TITLE
ONE-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, THE  COURT  SHALL
PRORATE  EACH  PARENT'S  SHARE  OF  THE  COST OF THE FAMILY CONTRIBUTION
REQUIRED UNDER SUCH CHILD HEALTH INSURANCE PLAN IN THE  SAME  PROPORTION
AS  EACH  PARENT'S  INCOME IS TO THE COMBINED PARENTAL INCOME, AND STATE
THE AMOUNT OF THE NON-CUSTODIAL PARENT'S SHARE IN THE ORDER.  THE  TOTAL
AMOUNT  OF CASH MEDICAL SUPPORT THAT THE NON-CUSTODIAL PARENT IS ORDERED
TO PAY UNDER THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT  OF  HIS  OR  HER
GROSS  INCOME,  OR  THE  DIFFERENCE  BETWEEN  THE NON-CUSTODIAL PARENT'S
INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (V) IN ADDITION TO THE AMOUNTS ORDERED UNDER CLAUSE  (II),  (III),  OR
(IV)  OF THIS SUBPARAGRAPH, THE COURT SHALL PRO RATE EACH PARENT'S SHARE
OF REASONABLE HEALTH CARE EXPENSES NOT REIMBURSED OR PAID BY  INSURANCE,
THE  MEDICAL  ASSISTANCE PROGRAM ESTABLISHED PURSUANT TO TITLE ELEVEN OF
ARTICLE FIVE OF THE SOCIAL SERVICES LAW, OR  THE  STATE'S  CHILD  HEALTH
INSURANCE  PLAN  PURSUANT  TO  TITLE ONE-A OF ARTICLE TWENTY-FIVE OF THE
PUBLIC HEALTH LAW, IN THE SAME PROPORTION AS EACH PARENT'S INCOME IS  TO
THE COMBINED PARENTAL INCOME, AND STATE THE NON-CUSTODIAL PARENT'S SHARE
AS  A PERCENTAGE IN THE ORDER. THE NON-CUSTODIAL PARENT'S PRO RATA SHARE
OF SUCH HEALTH CARE EXPENSES DETERMINED BY THE COURT TO BE DUE AND OWING
SHALL BE SUPPORT ARREARS/PAST DUE SUPPORT AND SHALL BE  SUBJECT  TO  ANY
REMEDIES PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE
SUPPORT.  IN  ADDITION,  THE  COURT  MAY  DIRECT  THAT THE NON-CUSTODIAL
PARENT'S PRO RATA SHARE OF SUCH HEALTH CARE EXPENSES BE PAID IN ONE  SUM
OR IN PERIODIC SUMS, INCLUDING DIRECT PAYMENT TO THE HEALTH CARE PROVID-
ER.
  (VI)  UPON PROOF BY EITHER PARTY THAT CASH MEDICAL SUPPORT PURSUANT TO
CLAUSE (II), (III), (IV) OR (V) OF THIS SUBPARAGRAPH WOULD BE UNJUST  OR
INAPPROPRIATE  PURSUANT  TO  PARAGRAPH  (F)  OF  SUBDIVISION ONE OF THIS
SECTION, THE COURT SHALL:
  (A) ORDER THE PARTIES TO PAY CASH MEDICAL SUPPORT AS THE  COURT  FINDS
JUST AND APPROPRIATE, CONSIDERING THE BEST INTERESTS OF THE CHILD; AND
  (B)  SET  FORTH  IN  THE  ORDER  THE FACTORS IT CONSIDERED, THE AMOUNT
CALCULATED UNDER THIS SUBPARAGRAPH, THE REASON OR REASONS THE COURT  DID
NOT ORDER SUCH AMOUNT, AND THE BASIS FOR THE AMOUNT AWARDED.
  S 2. Subparagraph 5 of paragraph (c) of subdivision 1-b of section 240
of  the  domestic  relations law is REPEALED and a new subparagraph 5 is
added to read as follows:
  (5) THE COURT SHALL  DETERMINE  THE  PARTIES'  OBLIGATION  TO  PROVIDE
HEALTH  INSURANCE  BENEFITS  PURSUANT  TO  THIS  SECTION AND TO PAY CASH
MEDICAL SUPPORT AS PROVIDED UNDER THIS SUBPARAGRAPH.

S. 4214--B                          4

  (I) "CASH MEDICAL SUPPORT" MEANS AN AMOUNT ORDERED TO BE  PAID  TOWARD
THE  COST OF HEALTH INSURANCE PROVIDED BY A PUBLIC ENTITY OR BY A PARENT
THROUGH AN EMPLOYER OR ORGANIZATION, INCLUDING SUCH EMPLOYERS OR  ORGAN-
IZATIONS  WHICH  ARE  SELF  INSURED,  OR  THROUGH OTHER AVAILABLE HEALTH
INSURANCE  OR  HEALTH  CARE COVERAGE PLANS, AND/OR FOR OTHER HEALTH CARE
EXPENSES NOT COVERED BY INSURANCE.
  (II) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPH ONE  AND
CLAUSES (I) AND (II) OF SUBPARAGRAPH TWO OF PARAGRAPH (C) OF SUBDIVISION
ONE  OF  THIS  SECTION  ARE DETERMINED BY THE COURT TO BE AVAILABLE, THE
COST OF PROVIDING HEALTH INSURANCE BENEFITS SHALL  BE  PRORATED  BETWEEN
THE  PARTIES  IN  THE  SAME PROPORTION AS EACH PARENT'S INCOME IS TO THE
COMBINED PARENTAL INCOME. IF THE CUSTODIAL PARENT IS ORDERED TO  PROVIDE
SUCH  BENEFITS,  THE NON-CUSTODIAL PARENT'S PRO RATA SHARE OF SUCH COSTS
SHALL BE ADDED TO THE BASIC SUPPORT  OBLIGATION.  IF  THE  NON-CUSTODIAL
PARENT  IS  ORDERED TO PROVIDE SUCH BENEFITS, THE CUSTODIAL PARENT'S PRO
RATA SHARE OF SUCH COSTS SHALL BE DEDUCTED FROM THE BASIC SUPPORT  OBLI-
GATION.
  (III) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPH ONE AND
CLAUSES (I) AND (II) OF SUBPARAGRAPH TWO OF PARAGRAPH (C) OF SUBDIVISION
ONE  OF  THIS  SECTION ARE DETERMINED BY THE COURT TO BE UNAVAILABLE, IF
THE CHILD OR CHILDREN ARE DETERMINED ELIGIBLE  FOR  COVERAGE  UNDER  THE
MEDICAL ASSISTANCE PROGRAM ESTABLISHED PURSUANT TO TITLE ELEVEN OF ARTI-
CLE  FIVE OF THE SOCIAL SERVICES LAW, THE COURT SHALL ORDER THE NON-CUS-
TODIAL PARENT TO PAY CASH MEDICAL SUPPORT AS FOLLOWS:
  (A) IN THE CASE OF A CHILD OR CHILDREN  AUTHORIZED  FOR  MANAGED  CARE
COVERAGE  UNDER THE MEDICAL ASSISTANCE PROGRAM, THE LESSER OF THE AMOUNT
THAT WOULD BE REQUIRED AS A FAMILY CONTRIBUTION UNDER THE STATE'S  CHILD
HEALTH  INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE OF
THE PUBLIC HEALTH LAW FOR THE CHILD  OR  CHILDREN  IF  THEY  WERE  IN  A
TWO-PARENT  HOUSEHOLD  WITH  INCOME  EQUAL TO THE COMBINED INCOME OF THE
NON-CUSTODIAL AND CUSTODIAL PARENTS OR THE PREMIUM PAID BY  THE  MEDICAL
ASSISTANCE  PROGRAM  ON  BEHALF  OF THE CHILD OR CHILDREN TO THE MANAGED
CARE PLAN. THE COURT SHALL SEPARATELY STATE THE  NON-CUSTODIAL  PARENT'S
MONTHLY  OBLIGATION.  THE  NON-CUSTODIAL  PARENT'S  CASH MEDICAL SUPPORT
OBLIGATION UNDER THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER
GROSS INCOME, OR  THE  DIFFERENCE  BETWEEN  THE  NON-CUSTODIAL  PARENT'S
INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (B)  IN THE CASE OF A CHILD OR CHILDREN AUTHORIZED FOR FEE-FOR-SERVICE
COVERAGE UNDER THE MEDICAL ASSISTANCE PROGRAM  OTHER  THAN  A  CHILD  OR
CHILDREN DESCRIBED IN ITEM (A) OF THIS CLAUSE, THE COURT SHALL DETERMINE
THE  NON-CUSTODIAL  PARENT'S  MAXIMUM  ANNUAL CASH MEDICAL SUPPORT OBLI-
GATION, WHICH SHALL BE EQUAL TO THE LESSER OF THE  MONTHLY  AMOUNT  THAT
WOULD  BE  REQUIRED  AS  A  FAMILY  CONTRIBUTION UNDER THE STATE'S CHILD
HEALTH INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE TWENTY-FIVE  OF
THE  PUBLIC  HEALTH  LAW  FOR  THE  CHILD  OR CHILDREN IF THEY WERE IN A
TWO-PARENT HOUSEHOLD WITH INCOME EQUAL TO THE  COMBINED  INCOME  OF  THE
NON-CUSTODIAL AND CUSTODIAL PARENTS TIMES TWELVE MONTHS OR THE NUMBER OF
MONTHS  THAT  THE  CHILD  OR CHILDREN ARE AUTHORIZED FOR FEE-FOR-SERVICE
COVERAGE DURING ANY YEAR. THE COURT SHALL SEPARATELY STATE IN THE  ORDER
THE  NON-CUSTODIAL  PARENT'S  MAXIMUM  ANNUAL CASH MEDICAL SUPPORT OBLI-
GATION AND, UPON PROOF TO THE COURT THAT THE NON-CUSTODIAL PARENT, AFTER
NOTICE OF THE AMOUNT DUE, HAS  FAILED  TO  PAY  THE  PUBLIC  ENTITY  FOR
INCURRED  HEALTH  CARE EXPENSES, THE COURT SHALL ORDER THE NON-CUSTODIAL
PARENT TO PAY SUCH INCURRED HEALTH CARE EXPENSES UP TO THE MAXIMUM ANNU-
AL CASH MEDICAL  SUPPORT  OBLIGATION.  SUCH  AMOUNTS  SHALL  BE  SUPPORT
ARREARS/PAST  DUE  SUPPORT  AND  SHALL  BE  SUBJECT  TO  ANY REMEDIES AS

S. 4214--B                          5

PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
THE TOTAL ANNUAL AMOUNT THAT THE NON-CUSTODIAL PARENT IS ORDERED TO  PAY
UNDER  THIS  CLAUSE  SHALL  NOT  EXCEED FIVE PERCENT OF HIS OR HER GROSS
INCOME  OR  THE DIFFERENCE BETWEEN THE NON-CUSTODIAL PARENT'S INCOME AND
THE SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (C) THE COURT SHALL ORDER CASH MEDICAL SUPPORT TO BE PAID BY THE  NON-
CUSTODIAL  PARENT FOR HEALTH CARE EXPENSES OF THE CHILD OR CHILDREN PAID
BY THE MEDICAL ASSISTANCE PROGRAM PRIOR TO THE ISSUANCE OF  THE  COURT'S
ORDER.  THE AMOUNT OF SUCH SUPPORT SHALL BE CALCULATED AS PROVIDED UNDER
ITEM (A) OR (B) OF THIS  CLAUSE,  PROVIDED  THAT  THE  AMOUNT  THAT  THE
NON-CUSTODIAL  PARENT IS ORDERED TO PAY UNDER THIS ITEM SHALL NOT EXCEED
FIVE PERCENT OF HIS OR HER GROSS INCOME OR THE  DIFFERENCE  BETWEEN  THE
NON-CUSTODIAL PARENT'S INCOME AND THE SELF-SUPPORT RESERVE, WHICHEVER IS
LESS,  FOR THE YEAR WHEN THE EXPENSE WAS INCURRED. SUCH AMOUNTS SHALL BE
SUPPORT ARREARS/PAST DUE SUPPORT AND SHALL BE SUBJECT TO ANY REMEDIES AS
PROVIDED BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT.
  (IV) WHERE HEALTH INSURANCE BENEFITS PURSUANT TO SUBPARAGRAPH ONE  AND
CLAUSES (I) AND (II) OF SUBPARAGRAPH TWO OF PARAGRAPH (C) OF SUBDIVISION
ONE  OF  THIS SECTION ARE DETERMINED BY THE COURT TO BE UNAVAILABLE, AND
THE CHILD OR CHILDREN ARE DETERMINED ELIGIBLE  FOR  COVERAGE  UNDER  THE
STATE'S  CHILD  HEALTH INSURANCE PLAN PURSUANT TO TITLE ONE-A OF ARTICLE
TWENTY-FIVE OF THE PUBLIC HEALTH  LAW,  THE  COURT  SHALL  PRORATE  EACH
PARENT'S  SHARE  OF  THE  COST OF THE FAMILY CONTRIBUTION REQUIRED UNDER
SUCH CHILD HEALTH INSURANCE PLAN IN THE SAME PROPORTION AS EACH PARENT'S
INCOME IS TO THE COMBINED PARENTAL INCOME, AND STATE THE AMOUNT  OF  THE
NON-CUSTODIAL  PARENT'S  SHARE  IN  THE  ORDER. THE TOTAL AMOUNT OF CASH
MEDICAL SUPPORT THAT THE NON-CUSTODIAL PARENT IS ORDERED  TO  PAY  UNDER
THIS CLAUSE SHALL NOT EXCEED FIVE PERCENT OF HIS OR HER GROSS INCOME, OR
THE  DIFFERENCE  BETWEEN  THE  NON-CUSTODIAL  PARENT'S  INCOME  AND  THE
SELF-SUPPORT RESERVE, WHICHEVER IS LESS.
  (V) IN ADDITION TO THE AMOUNTS ORDERED UNDER CLAUSE  (II),  (III),  OR
(IV),  THE COURT SHALL PRO RATE EACH PARENT'S SHARE OF REASONABLE HEALTH
CARE EXPENSES NOT REIMBURSED OR PAID BY INSURANCE, THE  MEDICAL  ASSIST-
ANCE PROGRAM ESTABLISHED PURSUANT TO TITLE ELEVEN OF ARTICLE FIVE OF THE
SOCIAL SERVICES LAW, OR THE STATE'S CHILD HEALTH INSURANCE PLAN PURSUANT
TO  TITLE  ONE-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW, IN THE
SAME PROPORTION AS EACH PARENT'S INCOME  IS  TO  THE  COMBINED  PARENTAL
INCOME,  AND  STATE  THE NON-CUSTODIAL PARENT'S SHARE AS A PERCENTAGE IN
THE ORDER. THE NON-CUSTODIAL PARENT'S PRO RATA SHARE OF SUCH HEALTH CARE
EXPENSES DETERMINED BY THE COURT TO BE DUE AND OWING  SHALL  BE  SUPPORT
ARREARS/PAST  DUE  SUPPORT AND SHALL BE SUBJECT TO ANY REMEDIES PROVIDED
BY LAW FOR THE ENFORCEMENT OF SUPPORT ARREARS/PAST DUE SUPPORT. IN ADDI-
TION, THE COURT MAY DIRECT THAT  THE  NON-CUSTODIAL  PARENT'S  PRO  RATA
SHARE  OF  SUCH  HEALTH  CARE EXPENSES BE PAID IN ONE SUM OR IN PERIODIC
SUMS, INCLUDING DIRECT PAYMENT TO THE HEALTH CARE PROVIDER.
  (VI) UPON PROOF BY EITHER PARTY THAT CASH MEDICAL SUPPORT PURSUANT  TO
CLAUSE (II), (III), (IV), OR (V) OF THIS SUBPARAGRAPH WOULD BE UNJUST OR
INAPPROPRIATE  PURSUANT  TO PARAGRAPH (F) OF THIS SUBDIVISION, THE COURT
SHALL:
  (A) ORDER THE PARTIES TO PAY CASH MEDICAL SUPPORT AS THE  COURT  FINDS
JUST AND APPROPRIATE, CONSIDERING THE BEST INTERESTS OF THE CHILD; AND
  (B)  SET  FORTH  IN  THE  ORDER  THE FACTORS IT CONSIDERED, THE AMOUNT
CALCULATED UNDER THIS SUBPARAGRAPH, THE REASON OR REASONS THE COURT  DID
NOT ORDER SUCH AMOUNT, AND THE BASIS FOR THE AMOUNT AWARDED.
  S 3. Subdivision (d) of section 416 of the family court act is amended
by adding a new paragraph 3 to read as follows:

S. 4214--B                          6

  (3) WHEN THE PERSON ON WHOSE BEHALF THE PETITION IS BROUGHT IS A CHILD
IN  ACCORDANCE  WITH  SUBDIVISION  (E) OF THIS SECTION, HEALTH INSURANCE
BENEFITS SHALL BE CONSIDERED "REASONABLE IN COST" IF THE COST OF  HEALTH
INSURANCE BENEFITS DOES NOT EXCEED FIVE PERCENT OF THE COMBINED PARENTAL
GROSS  INCOME.  THE COST OF HEALTH INSURANCE BENEFITS SHALL REFER TO THE
COST OF THE PREMIUM AND DEDUCTIBLE ATTRIBUTABLE TO ADDING THE  CHILD  OR
CHILDREN  TO  EXISTING COVERAGE OR THE DIFFERENCE BETWEEN SUCH COSTS FOR
SELF-ONLY AND FAMILY COVERAGE. PROVIDED, HOWEVER, THE  PRESUMPTION  THAT
THE  HEALTH  INSURANCE  BENEFITS  ARE REASONABLE IN COST MAY BE REBUTTED
UPON A FINDING THAT THE COST IS UNJUST OR  INAPPROPRIATE  WHICH  FINDING
SHALL BE BASED ON THE CIRCUMSTANCES OF THE CASE, THE COST AND COMPREHEN-
SIVENESS  OF  THE HEALTH INSURANCE BENEFITS FOR WHICH THE CHILD OR CHIL-
DREN MAY OTHERWISE BE ELIGIBLE, AND THE BEST INTERESTS OF THE  CHILD  OR
CHILDREN.   IN NO INSTANCE SHALL HEALTH INSURANCE BENEFITS BE CONSIDERED
"REASONABLE IN COST" IF A PARENT'S SHARE OF THE COST OF  EXTENDING  SUCH
COVERAGE  WOULD  REDUCE THE INCOME OF THAT PARENT BELOW THE SELF-SUPPORT
RESERVE. HEALTH INSURANCE BENEFITS ARE "REASONABLY  ACCESSIBLE"  IF  THE
CHILD  LIVES  WITHIN  THE  GEOGRAPHIC  AREA COVERED BY THE PLAN OR LIVES
WITHIN THIRTY MINUTES OR THIRTY MILES OF TRAVEL TIME  FROM  THE  CHILD'S
RESIDENCE  TO  THE  SERVICES COVERED BY THE HEALTH INSURANCE BENEFITS OR
THROUGH BENEFITS PROVIDED UNDER A RECIPROCAL AGREEMENT; PROVIDED, HOWEV-
ER, THIS PRESUMPTION MAY BE REBUTTED FOR GOOD CAUSE SHOWN INCLUDING, BUT
NOT LIMITED TO, THE SPECIAL HEALTH NEEDS OF THE CHILD.  THE COURT  SHALL
SET FORTH SUCH FINDING AND THE REASONS THEREFOR IN THE ORDER OF SUPPORT.
  S  4.  Paragraph  (b)  of subdivision 1 of section 240 of the domestic
relations law is amended by adding a  new  subparagraph  3  to  read  as
follows:
  (3) WHEN THE PERSON ON WHOSE BEHALF THE PETITION IS BROUGHT IS A CHILD
IN  ACCORDANCE  WITH PARAGRAPH (C) OF THIS SUBDIVISION, HEALTH INSURANCE
BENEFITS SHALL BE CONSIDERED "REASONABLE IN COST" IF THE COST OF  HEALTH
INSURANCE BENEFITS DOES NOT EXCEED FIVE PERCENT OF THE COMBINED PARENTAL
GROSS  INCOME.  THE COST OF HEALTH INSURANCE BENEFITS SHALL REFER TO THE
COST OF THE PREMIUM AND DEDUCTIBLE ATTRIBUTABLE TO ADDING THE  CHILD  OR
CHILDREN  TO  EXISTING COVERAGE OR THE DIFFERENCE BETWEEN SUCH COSTS FOR
SELF-ONLY AND FAMILY COVERAGE. PROVIDED, HOWEVER, THE  PRESUMPTION  THAT
THE  HEALTH  INSURANCE  BENEFITS  ARE REASONABLE IN COST MAY BE REBUTTED
UPON A FINDING THAT THE COST IS UNJUST OR  INAPPROPRIATE  WHICH  FINDING
SHALL BE BASED ON THE CIRCUMSTANCES OF THE CASE, THE COST AND COMPREHEN-
SIVENESS  OF  THE HEALTH INSURANCE BENEFITS FOR WHICH THE CHILD OR CHIL-
DREN MAY OTHERWISE BE ELIGIBLE, AND THE BEST INTERESTS OF THE  CHILD  OR
CHILDREN.   IN NO INSTANCE SHALL HEALTH INSURANCE BENEFITS BE CONSIDERED
"REASONABLE IN COST" IF A PARENT'S SHARE OF THE COST OF  EXTENDING  SUCH
COVERAGE  WOULD  REDUCE THE INCOME OF THAT PARENT BELOW THE SELF-SUPPORT
RESERVE. HEALTH INSURANCE BENEFITS ARE "REASONABLY  ACCESSIBLE"  IF  THE
CHILD  LIVES  WITHIN  THE  GEOGRAPHIC  AREA COVERED BY THE PLAN OR LIVES
WITHIN THIRTY MINUTES OR THIRTY MILES OF TRAVEL TIME  FROM  THE  CHILD'S
RESIDENCE  TO  THE  SERVICES COVERED BY THE HEALTH INSURANCE BENEFITS OR
THROUGH BENEFITS PROVIDED UNDER A RECIPROCAL AGREEMENT; PROVIDED, HOWEV-
ER, THIS PRESUMPTION MAY BE REBUTTED FOR GOOD CAUSE SHOWN INCLUDING, BUT
NOT LIMITED TO, THE SPECIAL HEALTH NEEDS OF THE CHILD.  THE COURT  SHALL
SET FORTH SUCH FINDING AND THE REASONS THEREFOR IN THE ORDER OF SUPPORT.
  S  5.  Subparagraph (iii) of paragraph 2 of subdivision (e) of section
416 of the family court act, as added by chapter  624  of  the  laws  of
2002, is amended to read as follows:
  (iii)  If  neither parent has available health insurance benefits, the
court shall direct in the order of support  that  the  custodial  parent

S. 4214--B                          7

apply  for  the  state's  child  health insurance plan pursuant to title
one-A of article twenty-five of the public health law  and  the  medical
assistance  program established pursuant to title eleven of article five
of  the  social  services law. [If eligible for such coverage, the court
shall prorate the cost of any premium or family contribution in  accord-
ance  with  subdivision  (f)  of this section.] A direction issued under
this subdivision shall not limit or alter either parent's obligation  to
obtain  health  insurance benefits at such time as they become available
as required pursuant to subdivision (c) of this  section.    NOTHING  IN
THIS  SUBDIVISION  SHALL  ALTER  OR  LIMIT  THE AUTHORITY OF THE MEDICAL
ASSISTANCE PROGRAM TO DETERMINE WHEN IT IS CONSIDERED COST EFFECTIVE  TO
REQUIRE  A  CUSTODIAL  PARENT  TO  ENROLL  A CHILD IN AN AVAILABLE GROUP
HEALTH INSURANCE PLAN PURSUANT TO PARAGRAPHS (B) AND (C) OF  SUBDIVISION
ONE OF SECTION THREE HUNDRED SIXTY-SEVEN-A OF THE SOCIAL SERVICES LAW.
  S  6. Clause (iii) of subparagraph 2 of paragraph (c) of subdivision 1
of section 240 of the domestic relations law, as amended by chapter  624
of the laws of 2002, is amended to read as follows:
  (iii)  If  neither parent has available health insurance benefits, the
court shall direct in the order of support  that  the  custodial  parent
apply  for  the  state's  child  health insurance plan pursuant to title
one-A of article twenty-five of the public health law  and  the  medical
assistance  program established pursuant to title eleven of article five
of the social services law. [If eligible for such  coverage,  the  court
shall  prorate the cost of any premium or family contribution in accord-
ance with paragraph (d) of this subdivision.] A direction  issued  under
this  subdivision shall not limit or alter either parent's obligation to
obtain health insurance benefits at such time as they become  available,
as  required  pursuant to paragraph (a) of this subdivision.  NOTHING IN
THIS SUBDIVISION SHALL ALTER OR  LIMIT  THE  AUTHORITY  OF  THE  MEDICAL
ASSISTANCE  PROGRAM TO DETERMINE WHEN IT IS CONSIDERED COST EFFECTIVE TO
REQUIRE A CUSTODIAL PARENT TO ENROLL  A  CHILD  IN  AN  AVAILABLE  GROUP
HEALTH INSURANCE PLAN PURSUANT TO PARAGRAPHS (B) AND (C)  OF SUBDIVISION
ONE OF SECTION THREE HUNDRED SIXTY-SEVEN-A OF THE SOCIAL SERVICES LAW.
  S  7.  Subdivision  (f)  of  section  416  of  the family court act is
REPEALED and a new subdivision (f) is added to read as follows:
  (F) THE COST OF PROVIDING HEALTH INSURANCE BENEFITS OR BENEFITS  UNDER
THE  STATE'S  CHILD  HEALTH  INSURANCE  PLAN  OR  THE MEDICAL ASSISTANCE
PROGRAM, PURSUANT TO SUBDIVISION (E) OF THIS SECTION,  SHALL  BE  DEEMED
CASH  MEDICAL  SUPPORT,  AND THE COURT SHALL DETERMINE THE OBLIGATION OF
EITHER OR BOTH PARENTS TO CONTRIBUTE TO THE  COST  THEREOF  PURSUANT  TO
SUBPARAGRAPH  FIVE  OF  PARAGRAPH (C) OF SUBDIVISION ONE OF SECTION FOUR
HUNDRED THIRTEEN OF THIS PART.
  S 8. Paragraph (d) of subdivision 1 of section  240  of  the  domestic
relations  law  is  REPEALED and a new paragraph (d) is added to read as
follows:
  (D) THE COST OF PROVIDING HEALTH INSURANCE BENEFITS OR BENEFITS  UNDER
THE  STATE'S  CHILD  HEALTH  INSURANCE  PLAN  OR  THE MEDICAL ASSISTANCE
PROGRAM, PURSUANT TO PARAGRAPH (C) OF THIS SUBDIVISION, SHALL BE  DEEMED
CASH  MEDICAL  SUPPORT,  AND THE COURT SHALL DETERMINE THE OBLIGATION OF
EITHER OR BOTH PARENTS TO CONTRIBUTE TO THE  COST  THEREOF  PURSUANT  TO
SUBPARAGRAPH FIVE OF PARAGRAPH (C) OF SUBDIVISION ONE-B OF THIS SECTION.
  S  9. Section 514 of the family court act, as amended by chapter 81 of
the laws of 1995, is amended to read as follows:
  S 514. Liability of father to mother. The father is  liable  [to  pay]
FOR the reasonable expenses of the mother's confinement and recovery and
such  reasonable expenses in connection with her pregnancy as DETERMINED

S. 4214--B                          8

BY the court [in its discretion may  deem  proper];  provided,  however,
where the mother's confinement, recovery and expenses in connection with
her  pregnancy  were  paid  under  the medical assistance program on the
mother's  behalf,  the  father  may  be  liable  to  the social services
district furnishing such medical assistance and to the state  department
of  [social services] HEALTH for [the full amount of] medical assistance
so expended[, as the court in its discretion may  deem  proper].    SUCH
EXPENSES, INCLUDING SUCH EXPENSES PAID BY THE MEDICAL ASSISTANCE PROGRAM
ON  THE  MOTHER'S  BEHALF,  SHALL BE DEEMED CASH MEDICAL SUPPORT AND THE
COURT SHALL DETERMINE THE OBLIGATION OF THE PARTIES TO CONTRIBUTE TO THE
COST THEREOF PURSUANT TO SUBPARAGRAPH FIVE OF PARAGRAPH (C) OF  SUBDIVI-
SION ONE OF SECTION FOUR HUNDRED THIRTEEN OF THIS ACT.
  S 10. Subdivision 1 of section 545 of the family court act, as amended
by chapter 214 of the laws of 1998, is amended to read as follows:
  1.  In a proceeding in which the court has made an order of filiation,
the court shall direct the parent or  parents  possessed  of  sufficient
means or able to earn such means to pay weekly or at other fixed periods
a  fair  and  reasonable  sum according to their respective means as the
court may determine and apportion for such child's  support  and  educa-
tion,  until the child is twenty-one. The order shall be effective as of
the earlier of the date of the application for an  order  of  filiation,
or,  if the children for whom support is sought are in receipt of public
assistance, the date for which their eligibility for  public  assistance
was  effective. Any retroactive amount of child support shall be support
arrears/past-due support and shall be paid in one sum or  periodic  sums
as  the  court shall direct, taking into account any amount of temporary
support which has been paid. In addition, such retroactive child support
shall be enforceable in any manner provided by law  including,  but  not
limited to, an execution for support enforcement pursuant to subdivision
(b) of section fifty-two hundred forty-one of the civil practice law and
rules.   The court shall direct such parent to make his or her residence
known at all times should he or she move from the address last known  to
the court by reporting such change to the support collection unit desig-
nated  by  the  appropriate  social  services  district. The order shall
contain the social security numbers of the named parents. The order  may
also  direct each parent to pay an amount as the court may determine and
apportion for the support of the child prior to the making of the  order
of  filiation,  and may direct each parent to pay an amount as the court
may determine and apportion for [(i)] the funeral expenses if the  child
has  died[;  (ii)  the].  THE  necessary expenses incurred by or for the
mother in connection with her confinement and  recovery[;]  and  [(iii)]
such  expenses  in  connection  with the pregnancy of the mother [as the
court may deem proper] SHALL BE DEEMED CASH  MEDICAL  SUPPORT,  AND  THE
COURT  SHALL  DETERMINE  THE  OBLIGATION  OF  EITHER  OR BOTH PARENTS TO
CONTRIBUTE TO THE COST THEREOF PURSUANT TO SUBPARAGRAPH  FIVE  OF  PARA-
GRAPH  (C)  OF  SUBDIVISION ONE OF SECTION FOUR HUNDRED THIRTEEN OF THIS
ACT.  In addition, the court shall make provisions for health  insurance
benefits  in  accordance  with  the requirements of section four hundred
sixteen of this act.
  S 11. Subparagraph (i) of paragraph 2 of subdivision  (b)  of  section
5241  of  the civil practice law and rules, as amended by chapter 533 of
the laws of 1999, is amended to read as follows:
  (i) Where the court orders the  debtor  to  provide  health  insurance
benefits  for  specified  dependents,  an  execution for medical support
enforcement may, except as provided for herein, be issued by the support
collection unit, or by the sheriff, the clerk of court or  the  attorney

S. 4214--B                          9

for  the  creditor  as  an officer of the court; provided, however, that
when the court issues an order of child support or  combined  child  and
spousal  support  on  behalf  of  persons other than those in receipt of
public  assistance  or  in  receipt  of services pursuant to section one
hundred eleven-g of the social  services  law,  such  medical  execution
shall be in the form of a separate qualified medical child support order
as  provided by subdivision [(f)] (J) of section four hundred sixteen of
the family court act and paragraph  [(f)]  (H)  of  subdivision  one  of
section  two hundred forty of the domestic relations law. Such execution
for medical support  enforcement  may  require  the  debtor's  employer,
organization or group health plan administrator to purchase on behalf of
the  debtor  and the debtor's dependents such available health insurance
benefits. Such execution shall  direct  the  employer,  organization  or
group  health  plan  administrator to provide to the dependents for whom
such benefits are required to be provided or such dependents'  custodial
parent  or  legal  guardian  or  social  services  district on behalf of
persons applying for or in receipt of public assistance any  identifica-
tion  cards  and  benefit  claim forms and to withhold from the debtor's
income the employee's share of the cost of such health  insurance  bene-
fits,  and to provide written confirmation of such enrollment indicating
the date such benefits were or become available or  that  such  benefits
are  not  available  and  the  reasons  therefor  to  the  issuer of the
execution. An  execution  for  medical  support  enforcement  shall  not
require  a debtor's employer, organization or group health plan adminis-
trator to purchase or  otherwise  acquire  health  insurance  or  health
insurance  benefits  that would not otherwise be available to the debtor
by reason of his or her employment or membership. Nothing  herein  shall
be  deemed  to  obligate or otherwise hold any employer, organization or
group health plan administrator responsible for an option  exercised  by
the  debtor  in  selecting  medical insurance coverage by an employee or
member.
  S 12. Subdivision (h) of section 5241 of the civil  practice  law  and
rules, as amended by chapter 398 of the laws of 1997, is amended to read
as follows:
  (h)  Priority.  A levy pursuant to this section or an income deduction
order pursuant to section 5242 of this chapter shall take priority  over
any other assignment, levy or process. If an employer or income payor is
served with more than one execution pursuant to this section, or with an
execution pursuant to this section and also an order pursuant to section
5242 of this chapter, and if the combined total amount of the deductions
to  be  withheld exceeds the limits set forth in subdivision (g) of this
section, the employer or income payor shall withhold the maximum  amount
permitted thereby and pay to each creditor that proportion thereof which
such  creditor's  claim  bears  to  the  combined  total. Any additional
deduction authorized by subdivision (g) of this section to be applied to
the reduction of arrears shall be applied to such arrears in  proportion
to  the  amount  of  arrears due to each creditor. Deductions to satisfy
CURRENT  support  obligations[,  including  any  additional   deductions
authorized by subdivision (g) of this section,] shall have priority over
deductions  for  the  debtor's  share of health insurance premiums WHICH
SHALL HAVE PRIORITY OVER ANY ADDITIONAL DEDUCTION AUTHORIZED BY SUBDIVI-
SION (G) OF THIS SECTION.
  S 13. This act shall take effect on the ninetieth day after  it  shall
have  become  a  law  and  shall apply to any proceeding to establish or
modify a child support obligation, including  a  medical  support  obli-
gation, commenced on or after such date.

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Senate Bill S4214

Signed By Governor

Sponsored By

Archive: Last Bill Status Via A8977 - Signed by Governor

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Jul 9, 2009 - Floor Vote

Floor Vote: Jul 9, 2009

Jun 30, 2009 - Rules Committee Vote

Rules Committee Vote: Jun 30, 2009

Bill Amendments

2009-S4214 - Details

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2009-S4214A - Details

2009-S4214A - Summary

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2009-S4214A - Bill Text download pdf

2009-S4214B (ACTIVE) - Details

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Senate Bill S4214

Signed By Governor

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Sponsored By

John L. Sampson

Archive: Last Bill Status Via A8977 - Signed by Governor

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Bill Amendments

2009-S4214 - Details

2009-S4214 - Summary

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2009-S4214 - Bill Text download pdf

2009-S4214A - Details

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2009-S4214B (ACTIVE) - Details

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