Ohio > County (Court Of Common Pleas) > Hamilton > Domestic Relations
Cash Medical Support Order 7.24 - Ohio
| Cash Medical Support Order Form. This is a Ohio form and can be used in Domestic Relations Hamilton County (Court Of Common Pleas) . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS HAMILTON COUNTY, OHIO Case No. Plaintiff -vsFile No. E: Date: CSEA # Defendant Cash Medical Support Order (__) The Obligor's annual income is less than or equal to 150% of the federal poverty level, therefore the Court makes no cash medical support order at this time. (__) The Obligor's annual income exceeds 150% of the federal poverty level, and neither party currently has private health insurance coverage available at a reasonable price for the child(ren). Therefore, the Court sets a cash medical order against the Obligor in the amount of $________ per month plus a 2% processing charge. This order is effective _______________ and is in addition to any existing child support order. Both parties shall notify the CSEA if private health insurance coverage for the children subject to this order becomes available. The CSEA shall determine whether the private health insurance provides accessible primary care services and is available at a reasonable cost. The cost is presumed reasonable if the annual cost of obtaining the coverage is five percent or less of the annual income of the party to whom it is available. If the CSEA determines that the private insurance is reasonably priced and accessible, the CSEA shall notify both parties that the person to whom the coverage is now available is ordered to secure and maintain health insurance for the child(ren) without an additional order or hearing. If private health insurance coverage for the child(ren) is obtained at a later date, the cash medical support previously established shall terminate on the last day of the month preceding the month in which private health insurance goes into effect. (__) The Obligor's annual income exceeds 150% of the federal poverty level, and one or both of the parties currently have available private health insurance coverage for the child(ren). Therefore, the Obligor is not ordered to pay cash medical support at this time. However, if private health insurance coverage for the children becomes unavailable or terminates, the Obligor shall be ordered to pay $_______ per month plus a 2% processing charge as cash medical support. This payment is in addition to any other existing child support order and shall become effective on the first day of the first month following the unavailability or termination of the private health insurance coverage on the child(ren). If the private health insurance coverage lapses, the child support order shall be modified to $______ per month plus a 2% processing charge. (See attached worksheet) This modification shall take effect on the first day of the first month following the termination of the health insurance coverage and without further notice to any party. Both parties are ordered to notify the CSEA immediately if the private health insurance coverage for the child(ren), subject to this order, becomes unavailable or lapses for any reason. ______________________________ Judge/Magistrate DR 7.24 (New 03/16/2009) American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
