(a) Available, affordable and accessible health insurance. — One or both parents shall be ordered to acquire private health insurance when it is available through employment, reasonable in cost and accessible to the child. Whether health insurance available to a parent other than through employment is reasonable in cost and should be acquired or maintained will be determined on a case by case basis.
(1) Reasonable cost.– In the context of establishing or modifying a child support obligation health insurance is reasonable in cost if:
(i) The premium to cover both the parent and the parent’s dependent children does not exceed ten percent (10%) of the parent’s gross income; and (ii) After inclusion of the insurance premium in the Formula, the parents’ combined net income pursuant to Rule 502 is sufficient to provide all primary expenses exclusive of private school tuition(2) Continuing duty to acquire insurance. If affordable coverage is not available at the time of the order or whenever coverage lapses, each parent shall be ordered to acquire coverage that becomes available if the cost to cover both the parent and the parent’s dependent children does not exceed ten percent (10%) of the parent’s gross income.(3) Accessibility. Health insurance is accessible to a child if it covers medical services within a reasonable distance from the child’s primary residence.(4) Termination. Once a parent has been ordered to acquire or maintain a specific policy of insurance, the parent shall continue the coverage despite changes in cost or accessibility until further order of the Court or written consent of the opposing party, or the State of Delaware if the child is a Medicaid recipient.(5) Specialized coverage. Whether either parent is required to acquire or maintain dental, vision or other specialized coverage shall be determined on a case-by-case basis. A National Medical Support Notice or medical support attachment shall not include specialized coverage unless expressly ordered.(b)Cash medical support. Every new or modified order for current support entered on or after January 1, 2015 shall impose an obligation of cash medical support on each parent who is a party to the petition.
(1) Cash medical support shall include all healthcare expenses not reimbursed by insurance, and incurred for the children for whom the order is entered. Such expenses include, but are not limited to, medical, dental, orthodontic, vision, and psychological counseling costs incurred on behalf of each child.(2) Each parent’s obligation for cash medical support shall be determined by multiplying the amount of unreimbursed healthcare expenses by the parent’s primary share percentage as defined in Rule 503(a).(3) An action for contribution to or reimbursement for a medical expense for a child may be brought at any time after the medical expense is incurred. However, any right of reimbursement will be presumed to have been waived unless a petition for reimbursement is filed with the Court by December 31 of the second year following the date the expense was incurred. This presumption may be rebutted for good cause shown.(4) Incurred. For purposes of this rule (including orders entered before 2015 that assigned the first $350 of healthcare expenses to the child support recipient), “incurred” shall be the date the medical healthcare service was provided, except that in the event a parent contracts to pay orthodontic or other long-term treatment services over a period of time the date each periodic payment is due under the contract shall be deemed to be the date the expense was “incurred.”
Del. Fam. Ct. R. Civ. P. 507
Amended eff. January 1, 2011; amended January 28, 2015, eff. April 20, 2015; amended November 8, 2018, effective February 1, 2019.
