Compliance with QMCSO

[karen1027]

Who is responsible for ensuring compliance with a QMCSO? The employer? The health insurance company? Employer keeps sending me back to the insurance company....

Plan is self-insured. According to QMCSO, reimbursement payments are to be made payable to alternate recipient.; however, checks go to non-custodial parent.

DOL states I must file my own lawsuit.

[leevena]

Who is responsible for ensuring compliance with a QMCSO? The employer? The health insurance company? Employer keeps sending me back to the insurance company....

Plan is self-insured. According to QMCSO, reimbursement payments are to be made payable to alternate recipient.; however, checks go to non-custodial parent.

DOL states I must file my own lawsuit.

Compliance is the responsibility of the Plan Administrator, which should be identified in a variety of documents made available to the covered employee. If you don't have any, the employer/employers' HR should know.

[karen1027]

Does a Plan Administrator ever make reimbursement payments to alternate recipients? Plan administrator keeps sending me back to the health insurance carrier who claims the insurance carrier can not make reimbursement payments to the alternate recipient.

[leevena]

Does a Plan Administrator ever make reimbursement payments to alternate recipients? Plan administrator keeps sending me back to the health insurance carrier who claims the insurance carrier can not make reimbursement payments to the alternate recipient.

I am not an attorney, nor an expert in this area, so please take this into consideration.

ERISA states that any payments from the plan that are reimbusing the alternate recipient should be paid to the alternate recipient. First thing I would do is to make sure that the plan has accepted the QMCSO and is reflected in their systems. If they still will not, then your prior answer is correct and you will probably need to file suit. Sorry.

[karen1027]

Thank you - that's what I thought. I've asked the Plan Adminstrator for additional documents. ii.e. their QMCSO procedures - they just ignore the request....

The health insurance carrier claims they can't (nor do they have to) reimburse me; however, for a very brief period last year (about two months) I received checks from the health insuance carrier after spending an inordinate amount of time trying to get directly reimbursed.

The past 8 months I've received nothing. The contract with the insurer has been in effect since 1/1/11.

Been advised to get an employee benefits attorney - is that correct?

[leevena]

Thank you - that's what I thought. I've asked the Plan Adminstrator for additional documents. ii.e. their QMCSO procedures - they just ignore the request....

The health insurance carrier claims they can't (nor do they have to) reimburse me; however, for a very brief period last year (about two months) I received checks from the health insuance carrier after spending an inordinate amount of time trying to get directly reimbursed.

The past 8 months I've received nothing. The contract with the insurer has been in effect since 1/1/11.

Been advised to get an employee benefits attorney - is that correct?

Again, I am not an expert, but if this were me I would be talking to an attorney.