Okla. Stat. tit. 43, § 43-118F

A. The court shall enter a medical support order for health

care coverage in any case in which an ongoing child support order is

entered or modified. Medical support, for the purpose of this

section, is defined as health care coverage, cash medical support,

or a combination of both. For the purposes of this section:

1. "Health care coverage" includes:

a. fee for service,

b. health maintenance organization,

c. preferred provider organization,

d. other types of private health insurance,

e. government medical assistance program or health plan,

f. Indian Health Services, and

g. Defense Eligibility Enrollment Reporting System

(DEERS).

2. "Cash medical support" means:

a. an amount ordered to be paid toward the cost of health

care coverage provided by a public entity, parent, or

by a person other than the parents, or

b. fixed periodic payments for ongoing medical costs.

B. In entering a temporary order, the court shall order that

any health care coverage in effect for the child continue in effect

pending the entering of a final order, unless the court finds that

the existing health care coverage is not reasonable in cost or is

not accessible as defined in subsection D of this section. If there

is no health care coverage in effect for the child or if the health

care coverage in effect is not available at a reasonable cost or is

not accessible, the court shall order health care coverage for the

child as provided in this section, unless the court makes a written

finding that good cause exists not to enter a temporary medical

support order.

C. On entering a final order, the court shall:

1. Make specific orders with respect to the manner in which

health care coverage is to be provided for the child; and

2. Require the parent ordered to provide health care coverage

for the child as provided under this section to produce evidence to

the court's satisfaction that the parent has applied for or secured

health care coverage or has otherwise taken necessary action to

Oklahoma Statutes - Title 43. Marriage and Family Page 90

provide for health care coverage for the child, as ordered by the

court.

D. When the court enters a medical support order, the medical

support order shall be reasonable in cost and accessible.

1. "Reasonable in cost" means that the pro rata share of the

actual premium cost for the child or children paid by the insured

does not exceed five percent (5%) of the gross income of the

responsible parent. To calculate the actual premium cost of the

health insurance, the court shall:

a. deduct from the total insurance premium the cost of

coverage for the parent and any other adults in the

household,

b. divide the remainder by the number of dependent

children being covered, and

c. multiply the amount per child by the number of

children in the child support case under

consideration.

2. "Accessible health care coverage" means that:

a. there are available providers appropriate to meet the

primary individual health care needs of the children

no more than sixty (60) miles one way from the primary

residence of the children.

b. If a parent has available health care coverage which

includes an option that would be accessible to the

child, but the parent has not currently enrolled in

that option, the court may require the parent to

change existing coverage to an option that is

accessible to the child.

3. If the parties agree or the court finds good cause exists,

the court may order health care coverage in excess of the five

percent (5%) cost standard or the sixty-mile distance standard.

E. The court shall consider the cost and quality of health care

coverage available to the parties. If both parents have health care

coverage available, the court shall give priority to the preference

of the custodial person, unless it is not in the best interest of

the child.

F. Cash medical support.

1. The responsible parent shall be ordered to pay cash medical

support when:
nce standard.

E. The court shall consider the cost and quality of health care

coverage available to the parties. If both parents have health care

coverage available, the court shall give priority to the preference

of the custodial person, unless it is not in the best interest of

the child.

F. Cash medical support.

1. The responsible parent shall be ordered to pay cash medical

support when:

a. there is no health care plan available for the child,

b. the only health care plan available for the child is a

governmental medical assistance program or health

plan, or

c. a party shows reasonable evidence of domestic violence

or child abuse, such that an order for health care

coverage is inappropriate and the disclosure of

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information could be harmful to a party, custodian, or

child.

2. The cash medical support order shall not exceed the pro rata

share of the actual monthly medical expenses paid for the child, or

five percent (5%) of the gross monthly income of the obligor,

whichever is less.

3. a. In determining the actual monthly medical costs for

the child, the court shall determine:

(1) for children who are participating in a

government medical assistance program or health

plan, an amount consistent with rules promulgated

by the Oklahoma Health Care Authority determining

the rates established for the cost of providing

medical care through a government medical

assistance program or health plan, or

(2) for children who are not participating in a

government medical assistance program or health

plan, an amount consistent with rules promulgated

by the Department of Human Services determining

the average monthly cost of health care for

uninsured children.

b. The court may also consider:

(1) proof of past medical expenses incurred by either

parent for the child,

(2) the current state of the health of the child, and

(3) any medical conditions of the child that would

result in an increased monthly medical cost.

G. An order requiring the payment of cash medical support under

subsection F of this section shall allow the obligor to terminate

payment of the cash medical support if:

1. Accessible health care coverage for the child becomes

available to the obligor at a reasonable cost; and

2. The obligor:

a. enrolls the child in the insurance plan, and

b. provides the obligee and, in a Title IV-D case, the

Title IV-D agency, the information required under

paragraph 2 of subsection C of this section.

In Title IV-D cases, termination and reinstatement of cash

medical support shall be according to rules promulgated by the

Department of Human Services.

H. 1. The actual health care premium for the child shall be

allocated between the parents in the same proportion as their

adjusted gross income and shall be added to the base child support

obligation.

2. If the obligor pays the health care premium, the obligor

shall receive credit against the base child support obligation for

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the allocated share of the health care premium for which the obligee

is responsible.

3. If the obligee pays the health care premium, the obligor

shall pay the allocated share of the health care premium to the

obligee in addition to the base child support obligation.

4. The parent providing the health care coverage shall furnish

to the other parent and to the Child Support Enforcement Division of

the Department of Human Services, if services are being provided

pursuant to Title IV, Part D of the Social Security Act, 42 U.S.C.

Section 601 et seq., with timely written documentation of any change

in the amount of the health care cost premium, carrier, or benefits

within thirty (30) days of the date of the change. Upon receiving

timely notification of the change of cost, the other parent is

responsible for his or her percentage share of the changed cost of

the health care coverage.
the Social Security Act, 42 U.S.C.

Section 601 et seq., with timely written documentation of any change

in the amount of the health care cost premium, carrier, or benefits

within thirty (30) days of the date of the change. Upon receiving

timely notification of the change of cost, the other parent is

responsible for his or her percentage share of the changed cost of

the health care coverage.

5. If the court finds that the obligor has underpaid child

support due to changes in the cost of health care coverage, the

amount of underpayment may be established as a judgment by the court

and enforced in the same manner as any other delinquent child

support judgment. If the court finds that the obligor has overpaid

due to changes in health care coverage cost, the overpayment shall

be satisfied:

a. by offset against any past-due child support owed to

the obligee, or

b. by adjustment to the future child support amount over

a thirty-six-month period, unless the court finds that

a thirty-six month period is not in the best interest

of the child.

I. Reasonable and necessary medical, dental, orthodontic,

optometric, psychological, or any other physical or mental health

expenses of the child incurred by either parent and not paid or

reimbursed by insurance or included in a cash medical support order

pursuant to subsection F of this section shall be allocated in the

same proportion as the adjusted gross income of the parents, unless

the parents agree to a different allocation of expenses and the

court finds such allocation is in the best interest of the child.

If reimbursement is required for a health care expense not included

in the current monthly child support obligation, the parent who

incurs the expense shall provide the other parent with proof of the

expense within forty-five (45) days of receiving the Explanation of

Benefits from the insurance provider or other proof of the expense

if the expense is not covered by insurance. The parent responsible

for reimbursement shall pay his or her portion of the expense within

forty-five (45) days of receipt of documentation of the expense.

J. In addition to any other sanctions ordered by the court, a

parent incurring uninsured dependent health expenses or increased

insurance premiums may be denied the right to receive credit or

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reimbursement for the expense or increased premium if that parent

fails to comply with subsections H and I of this section.

K. The parent desiring an adjustment to the ongoing child

support order due to a change in the amount of dependent health

insurance premium shall initiate a review of the order in accordance

with Section 118I of this title.