Qualified Medical Child Support Orders
Federal law requires employer-sponsored group health plans to recognize Qualified Medical Child Support Orders (QMCSOs) by providing benefits for eligible children of plan participants in accordance with the terms of the orders. A court order must identify the child who is the "alternate recipient" of health coverage, describe the type and duration of coverage, and cannot require a health plan to provide benefits which are not otherwise available under the Plan. The Company will determine if a court order satisfies the legal requirements to be a QMCSO in accordance with the written procedures established under the Plan. You may request a copy of the procedures, free of charge, by contacting the PG&E Benefits Service Center at 866-271-8144 (open weekdays from 7:30 a.m. to 5 p.m. Pacific time).
You will be notified of the receipt of an order affecting your children and the Company's procedures and determination with respect to the order. If an order satisfies the legal requirements, coverage may be provided for your child until the earlier of:
  • The date the coverage stops as provided in the order;
  • Your termination of coverage as a Retiree or Surviving Dependent (subject to your right to elect continuation of coverage); or
  • The date the child ceases to be an Eligible Dependent.
The Company will enroll the child pursuant to the court order and deduct any required contributions, even without the participant's direct consent. If you are not already enrolled, you must elect to participate at the time you are required to provide coverage for your child(ren); you may not enroll your child(ren) unless you also elect coverage for yourself. If you are enrolled in a health care program that will not cover dependent children who do not reside with you, you may change to a program for which you are eligible that will cover your children. If you do not voluntarily change, the Company will enroll you in the Network Access Plan (NAP) or the Comprehensive Access Plan (CAP), as appropriate for your home ZIP Code, and will deduct the required monthly contributions associated with NAP or CAP, or set you up for direct billing if needed.