15 AAC 125.427. Contesting medical support withholding

(a) The agency will notify the parents and a child support agency of another state, if appropriate, when a notice to withhold for health care coverage has been sent to a parent's employer under 15 AAC l25.426(a). The notice will be sent by first class mail or by electronic means. In the notice, the agency will describe the procedures that a party must follow if the party wishes to contest the withholding.

(b) A parent may contest the withholding for health care coverage by requesting an administrative review within 30 days after the date on which the notice was sent to the parent under (a) of this section or at any time after a material change in circumstances occurs that affects the need for or availability of coverage. The request must be in writing, state the specific reasons for the contest, and be accompanied by the documentation upon which the parent requesting the review intends to rely.

(c) The agency's administrative review under this section is limited to whether a mistake of fact has occurred, including whether

(1) the parent is required to provide health care coverage for the children through an employment-related group health plan;

(2) health care coverage through an employment-related group health plan is available to the parent at a reasonable cost;

(3) health care coverage is available at a reasonable cost to the other parent through an employment-related group health plan and that coverage better meets the needs of the children;

(4) the children are eligible for alternative health care coverage and the coverage is available for the children; or

(5) unusual circumstances exist relating to health care coverage, including

(A) extraordinary medical or other needs of the children;

(B) unusual hardship to a parent or a parent's family;

(D) the effect of coverage or lack of coverage on the interests of the children; and

(E) any agreement by the parents on health care coverage.

(d) A request based on a claim that alternative health care coverage is available for the children must include proof of the alternative coverage. As proof of alternative coverage, the requestor may include, for the agency's consideration under (f) of this section,

(1) health care coverage available through the employer of either parent's spouse, or of any other family member;

(2) health care coverage that is purchased by either parent and is not an employment-related group health plan; or

(3) privately or publicly funded health care services, including services available to tribal members and military personnel, but not including Medicaid benefits unless authorized as alternative coverage under federal law.

(e) The agency will conduct an administrative review within 20 days after it receives the written request under (b) of this section. An administrative appeal is not available from an administrative review decision issued under this subsection, but the decision is final for the purpose of appeal to the superior court.

(f) The agency will allow alternative coverage as a substitute for employment-related coverage under (c)(4) of this section only if

(1) the court or administrative support order stipulates to alternative coverage or the order does not specify the type of coverage to be provided; and

(2) after consultation with the parents and an assessment of which coverage would better meet the health care needs of the child at a reasonable cost, the agency makes a determination to allow alternative coverage as a substitute for a parent's employment-related coverage.

(g) Withholding by the employer for employee contributions for health care coverage under 15 AAC 125.426(d) must continue while an administrative review is pending under this section.

History: Eff. 11/30/2002, Register 164

Authority: AS 25.27.020

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