252E.1  Definitions.

As used in this chapter, unless the context otherwise requires:

1.  "Accessible" means any of the following, unless otherwise provided in the support order:

a.  The health benefit plan does not have service area limitations or provides an option not subject to service area limitations.

b.  The health benefit plan has service area limitations and the dependent lives within thirty miles or thirty minutes of a network primary care provider.

2.  "Basic coverage" means coverage provided under a health benefit plan that at a minimum provides coverage for emergency care, inpatient and outpatient hospital care, physician services whether provided within or outside a hospital setting, and laboratory and x-ray services.

3.  "Child" means a person for whom child or medical support may be ordered pursuant to chapter 234, 239B, 252A, 252C, 252F, 252H, 252K, 598, 600B, or any other chapter of the Code or pursuant to a comparable statute of a foreign jurisdiction.

4.  "Department" means the department of human services, which includes but is not limited to the child support recovery unit, or any comparable support enforcement agency of another state.

5.  "Dependent" means a child, or an obligee for whom a court may order coverage by a health benefit plan pursuant to section 252E.3.

6.  "Enroll" means to be eligible for and covered by a health benefit plan.

7.  "Health benefit plan" means any policy or contract of insurance, indemnity, subscription or membership issued by an insurer, health service corporation, health maintenance organization, or any similar corporation, organization, or a self-insured employee benefit plan, for the purpose of covering medical expenses. These expenses may include but are not limited to hospital, surgical, major medical insurance, dental, optical, prescription drugs, office visits, or any combination of these or any other comparable health care expenses.

8.  "Insurer" means any entity which provides a health benefit plan.

9.  "Medical support" means either the provision of a health benefit plan, including a group or employment-related or an individual health benefit plan, or a health benefit plan provided pursuant to chapter 514E, to meet the medical needs of a dependent and the cost of any premium required by a health benefit plan, or the payment to the obligee of a monetary amount in lieu of a health benefit plan, either of which is an obligation separate from any monetary amount of child support ordered to be paid. Medical support is not alimony.

10.  "National medical support notice" means a notice as prescribed under 42 U.S.C. § 666(a)(19) or a substantially similar notice, that is issued and forwarded by the department to enforce medical support provisions of a support order.

11.  "Obligee" means a parent or another natural person legally entitled to receive a support payment on behalf of a child.

12.  "Obligor" means a parent or another natural person legally responsible for the support of a dependent.

13.  "Order" means a support order entered pursuant to chapter 234, 252A, 252C, 252F, 252H, 252K, 598, 600B, or any other support chapter, or pursuant to a comparable statute of a foreign jurisdiction, or an ex parte order entered pursuant to section 252E.4. "Order" also includes a notice of such an order issued by the department.

14.  "Plan administrator" means the employer or sponsor that offers the health benefit plan or the person to whom the duty of plan administrator is delegated by the employer or sponsor offering the health benefit plan, by written agreement of the parties.

15.  "Primary care provider" means a physician who provides primary care who is a family or general practitioner, a pediatrician, an internist, an obstetrician, or a gynecologist.

Section History: Recent form

  90 Acts, ch 1224, § 25; 92 Acts, ch 1195, § 505; 93 Acts, ch 78, §20; 93 Acts, ch 79, §46; 97 Acts, ch 41, § 32; 2000 Acts, ch 1096, §1; 2002 Acts, ch 1018, §3


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