QMCSO Sample Clauses

A QMCSO, or Qualified Medical Child Support Order, is a legal directive that requires a group health plan to provide coverage to a child of a plan participant, typically as part of a divorce or child support arrangement. This clause outlines the process by which such orders are recognized and enforced by the health plan, including the criteria the order must meet and the responsibilities of the plan administrator. By ensuring that children receive health coverage even when parents are separated or divorced, the QMCSO clause addresses the need for continued medical support and clarifies the obligations of all parties involved.
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QMCSO. QMCSO" means a medical child support order which qualifies under ERISA Section 609(a) and which creates or recognizes the existence of an alternate recipient's right to, or assigns to an alternate recipient the right to, receive benefits for which a participant or beneficiary is eligible under any of the Health Plans.
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QMCSO. In the event the Plan Administrator receives a medical child support order (within the meaning of ERISA Section 609(a)(2)(B)), the Plan Administrator shall notify the affected Participant and any alternate recipient identified in the order of the receipt of the order and the Plan’s procedures for determining whether such an order is a qualified medical child support order (within the meaning of ERISA Section 609(a)(2)(A)). Within a reasonable period, the Plan Administrator shall determine whether the order is a qualified medical child support order and shall notify the Participant and alternate recipient of such determination.
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QMCSO. A “qualified medical child support order” as that term is defined in Section 609(a) of ERISA. The term “QMCSO” includes a “National Medical Support Notice” deemed to constitute a qualified medical child support order pursuant to Section 609(a)(5)(C) of ERISA. A “qualified beneficiary” within the meaning of 26 C.F.R. § 54.4980B-3. Generally, this means any individual who is, as of the day before a Qualifying Event, (i) an employee covered under health benefits offered under the Plan as of such day; (ii) the Spouse of the Participant; or (iii) a Dependent child of the Participant. An employee can be a Qualified Beneficiary only if the Qualifying Event consists of termination of employment (other than for gross misconduct) or a reduction of hours of the employee’s employment. A child born or placed for adoption with an employee or former employee during COBRA continuation coverage will also be considered as a Qualified Beneficiary (to the extent required by COBRA). A former employee actively participating in the Plan by reason of a previous period of employment may also be treated as a Qualified Beneficiary for purposes of the COBRA rules. A “qualified health plan” within the meaning of Section 1301 of the Affordable Care Act. A “qualifying event” within the meaning of Section 4980B(f)(3) of the Code.
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QMCSO. A qualified medical child support order, as defined in ERISA Section 609(a).
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Related to QMCSO

  • Qualified Medical Child Support Order A child who would otherwise meet the eligibility requirements and is required to be covered by a Qualified Medical Child Support Order (QMCSO) is considered an eligible dependent.

  • Medi Cal/daily service logs and notes and other documents used to record provision of services provided by instructional assistants, behavior intervention aides, bus aides, and supervisors

  • Chiropractic Services This plan covers chiropractic visits up to the benefit limit shown in the Summary of Medical Benefits. The benefit limit applies to any visit for the purposes of chiropractic treatment or diagnosis.

  • Domestic Relations Orders If any judgment, decree or order (including approval of a property settlement agreement) which (i) relates to the provision of child support, alimony payments, or marital property rights to a spouse, former spouse, child, or other dependent of a Participant, and (ii) is made pursuant to a state or foreign domestic relations law (including a community property law) directs assignment of a portion of a Participant’s Account to a spouse, former spouse, child, or other dependent of a Participant, such amount may be paid in a lump-sum cash payment at the request of the person to whom assignment is directed to be made as soon as administratively possible after the Administrator’s receipt of the signed order, as long as the order (or a written direction to the Administrator of how to interpret the order, signed by the Participant and the person to whom the order directs assignment) clearly specifies the amount of the Account assigned and the timing of payment to the person to whom the assignment is made.

  • Durable Medical Equipment (DME), Medical Supplies Prosthetic Devices, Enteral Formula or Food, and Hair Prosthesis (Wigs) • Items typically found in the home that do not need a prescription and are easily obtainable such as, but not limited to: o adhesive bandages; o elastic bandages; o gauze pads; and o alcohol swabs. • DME and medical supplies prescribed primarily for the convenience of the member or the member’s family, including but not limited to, duplicate DME or medical supplies for use in multiple locations or any DME or medical supplies used primarily to assist a caregiver. • Non-wearable automatic external defibrillators. • Replacement of durable medical equipment and prosthetic devices prescribed because of a desire for new equipment or new technology. • Equipment that does not meet the basic functional need of the average person. • DME that does not directly improve the function of the member. • Medical supplies provided during an office visit. • Pillows or batteries, except when used for the operation of a covered prosthetic device, or items for which the sole function is to improve the quality of life or mental wellbeing. • Repair or replacement of DME when the equipment is under warranty, covered by the manufacturer, or during the rental period. • Infant formula, nutritional supplements and food, or food products, whether or not prescribed, unless required by R.I. Law §27-20-56 for Enteral Nutrition Products, or delivered through a feeding tube as the sole source of nutrition. • Corrective or orthopedic shoes and orthotic devices used in connection with footwear, unless for the treatment of diabetes. • Treatments, procedures, facilities, equipment, drugs, devices, supplies, or services that are experimental or investigational except as described in Section 3. • Reversal of gender reassignment surgery.