Section 416. Elements of support; provisions for accident, life and health insurance benefits

(a) The court may include in the requirements for an
  order for support the providing of necessary  shelter,  food,  clothing,
  care,  medical  attention,  expenses  of  confinement,  the  expense  of
  education, payment of funeral expenses, and other proper and  reasonable
  expenses.
    (b)  The court may also order a party to purchase, maintain, or assign
  a policy of accident insurance or insurance on the life of either  party
  and  designate  in  the case of life insurance, the person or persons on
  whose behalf the  petition  is  brought  or  in  the  case  of  accident
  insurance,  the  insured  party  as  irrevocable  beneficiaries during a
  period of time fixed by  the  court.  The  obligation  to  provide  such
  insurance  shall  cease  upon  the  termination  of such party's duty to
  provide support.
    (c) Every support order shall provide that if any legally  responsible
  relative  currently,  or at any time in the future, has health insurance
  benefits available that may be extended or obtained to cover any  person
  on  whose  behalf  the petition is brought, such responsible relative is
  required to exercise the option of additional coverage in favor of  such
  person  whom  he or she is legally responsible to support and to execute
  and deliver to such person any forms, notices, documents, or instruments
  to assure timely payment of any health insurance claims for such person.
    (d) As used in this  section,  the  following  terms  shall  have  the
  following  meanings:  (1) "Health insurance benefits" means any medical,
  dental, optical and prescription drugs and health care services or other
  health care benefits that may be provided for  a  dependent  through  an
  employer  or  organization,  including  such  employers or organizations
  which are self insured, or through other available health  insurance  or
  health care coverage plans.
    (2)  "Available  health insurance benefits" means any health insurance
  benefits that are reasonable in cost and that are reasonably  accessible
  to  the person on whose behalf the petition is brought. Health insurance
  benefits that are not reasonable in  cost  or  whose  services  are  not
  reasonably accessible to such person shall be considered unavailable.
    * (3)  When  the  person  on whose behalf the petition is brought is a
  child in  accordance  with  subdivision  (e)  of  this  section,  health
  insurance  benefits shall be considered "reasonable in cost" if the cost
  of health insurance  benefits  does  not  exceed  five  percent  of  the
  combined  parental  gross  income. The cost of health insurance benefits
  shall refer to the cost of the premium and  deductible  attributable  to
  adding  the  child  or  children  to existing coverage or the difference
  between such costs for self-only and family coverage. Provided, however,
  the presumption that the health insurance  benefits  are  reasonable  in
  cost  may  be  rebutted  upon  a  finding  that  the  cost  is unjust or
  inappropriate which finding shall be based on the circumstances  of  the
  case,  the  cost  and comprehensiveness of the health insurance benefits
  for which the child or children may otherwise be eligible, and the  best
  interests  of  the  child  or  children.  In  no  instance  shall health
  insurance benefits be considered "reasonable  in  cost"  if  a  parent's
  share  of the cost of extending such coverage would reduce the income of
  that parent below the self-support reserve.  Health  insurance  benefits
  are  "reasonably  accessible"  if  the child lives within the geographic
  area covered by the plan or lives within thirty minutes or thirty  miles
  of travel time from the child's residence to the services covered by the
  health   insurance   benefits  or  through  benefits  provided  under  a
  reciprocal  agreement;  provided,  however,  this  presumption  may   be
  rebutted for good cause shown including, but not limited to, the special

  health  needs  of the child.  The court shall set forth such finding and
  the reasons therefor in the order of support.
    * NB Effective October 9, 2009
    (e)  When  the  person  on  whose  behalf the petition is brought is a
  child, the court shall consider the  availability  of  health  insurance
  benefits  to  all  parties and shall take the following action to insure
  that health insurance benefits are  provided  for  the  benefit  of  the
  child:
    (1) Where the child is presently covered by health insurance benefits,
  the  court  shall  direct  in the order of support that such coverage be
  maintained, unless either parent requests the court to make a  direction
  for health insurance benefits coverage pursuant to paragraph two of this
  subdivision.
    (2)  Where  the  child  is  not  presently covered by health insurance
  benefits, the court shall make its determination as follows:
    (i) If only one parent has available health  insurance  benefits,  the
  court  shall  direct  in  the  order of support that such parent provide
  health insurance benefits.
    (ii) If both parents have  available  health  insurance  benefits  the
  court  shall  direct  in the order of support that either parent or both
  parents provide  such  health  insurance.  The  court  shall  make  such
  determination based on the circumstances of the case, including, but not
  limited  to,  the  cost  and  comprehensiveness of the respective health
  insurance benefits and the best interests of the child.
    * (iii) If neither parent has available health insurance benefits, the
  court shall direct in the order of support  that  the  custodial  parent
  apply  for  the  state's  child  health insurance plan pursuant to title
  one-A of article twenty-five of the public health law  and  the  medical
  assistance  program established pursuant to title eleven of article five
  of the social services law. If eligible for  such  coverage,  the  court
  shall  prorate  the  cost  of  any  premium  or  family  contribution in
  accordance with subdivision (f) of  this  section.  A  direction  issued
  under  this  subdivision  shall  not  limit  or  alter  either  parent's
  obligation to obtain health insurance benefits  at  such  time  as  they
  become  available  as  required  pursuant  to  subdivision  (c)  of this
  section.
    * NB Effective until October 9, 2009
    * (iii) If neither parent has available health insurance benefits, the
  court shall direct in the order of support  that  the  custodial  parent
  apply  for  the  state's  child  health insurance plan pursuant to title
  one-A of article twenty-five of the public health law  and  the  medical
  assistance  program established pursuant to title eleven of article five
  of the social services law. A direction issued  under  this  subdivision
  shall  not  limit  or  alter either parent's obligation to obtain health
  insurance benefits at such time as they  become  available  as  required
  pursuant to subdivision (c) of this section. Nothing in this subdivision
  shall  alter or limit the authority of the medical assistance program to
  determine when it is considered cost effective to  require  a  custodial
  parent  to  enroll  a  child in an available group health insurance plan
  pursuant to paragraphs (b) and (c) of subdivision one of  section  three
  hundred sixty-seven-a of the social services law.
    * NB Effective October 9, 2009
    * (f)  The  cost  of  providing  health insurance benefits pursuant to
  subdivision (e) of this section shall be prorated between the parties in
  the same proportion as each parent's income is to the combined  parental
  income. If the custodial parent is ordered to provide such benefits, the
  non-custodial  parent's  pro  rata share of such costs shall be added to
  the basic support obligation. If the non-custodial parent is ordered  to

  provide  such  benefits,  the  custodial parent's pro rata share of such
  costs shall be deducted from the basic  support  obligation.  Where  the
  court  finds  that  such proration is unjust or inappropriate, the court
  shall:
    (1)  order  the  parties  to  pay  such  amount  of the cost of health
  insurance benefits as the court finds just and appropriate;
    (2) add or subtract such amount in the manner set forth herein; and
    (3) set forth in the order the factors it considered,  the  amount  of
  each  party's  share of the cost and the reason or reasons the court did
  not order such pro rata apportionment.
    * NB Effective until October 9, 2009
    * (f) The cost of providing  health  insurance  benefits  or  benefits
  under  the state's child health insurance plan or the medical assistance
  program, pursuant to subdivision (e) of this section,  shall  be  deemed
  cash  medical  support,  and the court shall determine the obligation of
  either or both parents to contribute to the  cost  thereof  pursuant  to
  subparagraph  five  of  paragraph (c) of subdivision one of section four
  hundred thirteen of this part.
    * NB Effective October 9, 2009
    (g) The court shall provide in the order of support that  the  legally
  responsible  relative  immediately  notify the other party, or the other
  party and the support collection unit when the order is issued on behalf
  of a child in receipt of public assistance and care  or  in  receipt  of
  services pursuant to section one hundred eleven-g of the social services
  law,   of  any  change  in  health  insurance  benefits,  including  any
  termination of benefits, change in the health insurance benefit carrier,
  premium, or extent and availability of existing or new benefits.
    (h) Where the court determines  that  health  insurance  benefits  are
  available,  the  court  shall  provide  in the order of support that the
  legally responsible relative immediately enroll the eligible  dependents
  named  in the order who are otherwise eligible for such benefits without
  regard to any seasonal enrollment restrictions. The support order  shall
  further  direct  the  legally  responsible  relative  to  maintain  such
  benefits as long as they remain available to such relative.  Such  order
  shall  further  direct  the  legally  responsible relative to assign all
  insurance reimbursement payments for health care expenses  incurred  for
  his  or  her eligible dependents to the provider of such services or the
  party  actually  having  incurred  and  satisfied  such   expenses,   as
  appropriate.
    (i)  When the court issues an order of child support or combined child
  and spousal support on behalf of persons in receipt of public assistance
  and care or in receipt of  services  pursuant  to  section  one  hundred
  eleven-g  of  the  social  services law, such order shall further direct
  that the provision of health care benefits shall be immediately enforced
  pursuant to section fifty-two hundred forty-one of  the  civil  practice
  law and rules.
    (j)  When the court issues an order of child support or combined child
  and spousal support on behalf of persons other than those in receipt  of
  public assistance and care or in receipt of services pursuant to section
  one  hundred  eleven-g  of the social services law, the court shall also
  issue a separate order which shall include the  necessary  direction  to
  ensure the order's characterization as a qualified medical child support
  order  as defined by section six hundred nine of the employee retirement
  income security act of 1974 (29 USC 1169). Such order shall: (i) clearly
  state that it creates or recognizes the existence of the  right  of  the
  named  dependent  to  be  enrolled and to receive benefits for which the
  legally responsible relative  is  eligible  under  the  available  group
  health plans, and shall clearly specify the name, social security number

  and  mailing  address  of  the legally responsible relative, and of each
  dependent to be covered by the order; (ii) provide a  clear  description
  of  the type of coverage to be provided by the group health plan to each
  such  dependent  or  the  manner  in which the type of coverage is to be
  determined; and (iii) specify the period of  time  to  which  the  order
  applies.  The  court  shall not require the group health plan to provide
  any type or form of benefit or option not otherwise provided  under  the
  group   health   plan  except  to  the  extent  necessary  to  meet  the
  requirements of a law relating to medical  child  support  described  in
  section one thousand three hundred and ninety-six g-1 of title forty-two
  of the United States code.
    (k) Upon a finding that a legally responsible relative wilfully failed
  to  obtain health insurance benefits in violation of a court order, such
  relative will be presumptively  liable  for  all  health  care  expenses
  incurred  on  behalf  of  such  dependents  from  the  first  date  such
  dependents were eligible to be  enrolled  to  receive  health  insurance
  benefits  after  the  issuance  of  the  order  of support directing the
  acquisition of such coverage.