252E.1 - DEFINITIONS.
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. Medical support which consists of payment of a
monetary amount in lieu of a health benefit plan is also an
obligation separate from any monetary amount a parent is ordered to
pay for uncovered medical expenses pursuant to the guidelines
established pursuant to section 598.21B.
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; 2007 Acts, ch 218, §163, 187; 2008 Acts,
ch 1019, §18, 20
Referred to in § 252C.1, 252E.6A, 514C.9, 600B.25 Footnotes
For transition provisions applicable to existing child support
recovery unit rules, procedures, definitions, and requirements, and
for nullification of 441 IAC rule 98.3, see 2007 Acts, ch 218, §186