Fox Family Lawyers
Cynthia Moseley Fox
Attorney at Law
7751 Carondelet Avenue,
Suite 700
Clayton, Missouri 63105
(St. Louis)

Do You Have a “Q-Order” in Your Divorce Decree? Is It Up-To-Date?

“Harry” sat in my office both angry and terrified. Three days before, his 7-year-old son had been rushed to the emergency room after falling from the tree house in the backyard. He suffered multiple fractures, including a broken back, and faced several operations and extensive rehabilitation. Thankfully, the prospects for a full recovery were excellent.

However, Harry has learned that the health insurance that his ex-wife had been ordered to provide for the boy had terminated several weeks earlier without his knowing it. His former spouse had worked at a machine shop that had gone out of business costing all the employees their jobs, and with them, their medical coverage.

Harry now faced the prospect of tens of thousands in medical bills without any coverage at all. How could he and his child have been left so vulnerable? Wasn’t someone…his “ex”, the insurance company…required to let him know that the coverage was ending?

Harry’s situation is not that unusual, unfortunately, and his vulnerability results from the failure of his divorce attorney and the judge presiding over the divorce to include a QMCSJO in the final decree. QMCSJO stands for a Qualified Medical Child Support Judgment Order (but, let’s just call it a “Q-Order”) and it’s just what Harry needed because it would have required the insurance plan administrator to notify him that the medical coverage was ending.

In Missouri, since 1993, the law has required that a Q-Order be included in every divorce where minor children are involved and where “reasonably affordable” health insurance for the children is available. Besides the notification requirement, the Q-Order authorizes the administrator to dip into the paycheck of the parent providing the insurance should that parent fail to pay the premiums.

Yet, despite being in effect for 12 years, the law requiring Q-Orders often is not enforced. In my experience, family court judges rarely check to see if one has been included in the final order. Many attorneys, and judges, seem to think that a Q-Order isn’t worth the extra effort because most final decrees include explicit language identifying which parent is responsible for providing medical insurance for the children.

The problem is that saying who provides the insurance doesn’t make it happen. The law requiring Q-Orders was mandated by the U.S. Congress because far too many divorced parents ignored their obligation to insure their children and the federal government was picking up the tab for their unpaid medical bills. As Harry was now discovering, by the time one learns there is no insurance, the devastating financial consequences are already upon you with slim prospects for recovery, particularly with an unemployed former spouse.

Having a Q-Order provides other benefits as well. The insurance company is empowered to deal directly with the parent not providing the coverage. This means that insurance cards and forms are sent directly, as are the names of approved providers and any reimbursement checks. Without a Q-Order, privacy laws prohibit the company from communicating with the “other parent” and all information and payments are routed through the parent providing the insurance. Too often, I have seen where those reimbursements never make it to the parent entitled to receive them.

So, if you are divorced with minor children, check your decree. It’s not too late to add a Q-Order, even for divorces finalized before 1993, working with a qualified attorney. Importantly, if you do have a Q-Order, make sure it’s up-to-date. If the parent providing the insurance has changed jobs, or the company providing the medical coverage has the changed, a new Q-Order has to be created naming the current plan administrator and health plan.