National Medical Support Notice SOP

Purpose

To standardize the intake, validation, and processing of court-ordered dependent enrollments while ensuring compliance, security, and clear ownership across teams.

Medical Child Support Order — SOP (Employer Processing Guide)

Step 1 — Receive and Review the Court Order

Before submitting a Coverage Change Request, the employer should review the court order and confirm all required information is present.

Confirm dependent information

Full name
Date of Birth (DOB)
Social Security Number (SSN)

Confirm legal guardian information

Legal guardian's mailing address
Legal guardian's email and phone number

This is needed if a separate dependent-only plan is required due to confidentiality.

Confirming that the premium is within the employee's withholding limits is solely the employer's responsibility. Benefitbay does not determine or verify withholding compliance. If court order information is confidential, handle it with care throughout the entire process.

Step 2 — Verify Active Employee Coverage

Before proceeding, confirm that the employee has active coverage enrolled. If an employee has waived coverage, they must enroll in a plan.

Key requirements

The employee must also elect coverage while adding a dependent
Benefitbay does not support waived employee enrollment + dependent-only enrollment
Employee must select plan or employer will select on employee's behalf

If the employee has no active coverage, the employer must educate the employee directly on why selecting a plan is required before moving forward. Due to confidentiality, the employer owns this conversation with the employee.

Step 3 — Submit a Coverage Change Request (click for help)

Once all information is confirmed, the employer is ready to begin the process with benefitbay.

The employer (not the employee) is responsible for submitting the request
Include the chosen enrollment direction in the request
The benefitbay Support Team will follow the employer's enrollment direction

Direction 1 — Employee already has active coverage

Option 1A — Non-confidential: Add dependent to employee's existing plan

Dependent added to the employee's selected plan using the employee's address
Support Team completes the dependent's enrollment

Because the dependent is added under the employee's address, the employee may have full visibility into the dependent's coverage through the carrier (member ID cards, carrier notifications, etc.). Benefitbay will input the child's information anonymously and redact personal details on the platform, but cannot prevent carrier-level visibility.

Option 1B — Confidential: Enroll dependent in a separate plan

Dependent enrolled in a separate plan using the legal guardian's address
Same plan as employee if available in the service area; otherwise, most similar plan is selected
Support Team completes enrollment — cannot contact the guardian directly, and a court address cannot be used since carriers require a residential mailing address

Direction 2 — Employee has no active coverage (has waived & will shop via SEP)

The employer must confirm how the Support Team should proceed once the employee enrolls, before opening the Special Enrollment Period.

Option 2A — Non-confidential: Add dependent to employee's selected plan using the employee's address

The employee enrolls the dependent themselves and must know the dependent's full name, DOB, and SSN. If they don't know this information, use Option 2B instead.

Because the dependent is added to the employee's existing plan under the employee's address, the employee may have full visibility into the dependent's coverage through the carrier (member ID cards, carrier notifications, etc.).

Option 2B — Confidential: Enroll dependent in a separate plan

Dependent enrolled in a separate plan using the legal guardian's address
Same plan as employee if available in the service area; otherwise, most similar plan is selected
Support Team completes enrollment — cannot contact the guardian directly, and a court address cannot be used since carriers require a residential mailing address

What Happens Next

Once the Coverage Change Request is submitted and direction is provided:

Customer Success Manager (CSM) sends the employer a secure upload link for the court order
Employer submits the court order via the secure link
Process is kicked off — QLE Manager and/or Employee Success Team proceeds with enrollment

Who sends the secure link: The CSM creates the secure link and provides education. Employers may inadvertently upload confidential information in a Coverage Change Request that could be visible to employees, so the CSM generates and shares the secure link directly with the employer to prevent employee access to sensitive information. Reference the internal knowledge article on creating a secure upload link.

If requirements cannot be met: If the employer cannot meet the order's requirements, they may respond to the court that the order cannot be completed. The child can then obtain coverage through Medicaid.

Roles & Responsibilities

Employer

Provides required documentation and education to the employee, and ensures the employee selects a plan if the employer will decide how to proceed
Determines coverage direction
Confirms the premium is within applicable withholding limits (benefitbay does not verify this)

Customer Success Manager

Provides education to the employer around the process
Supports the employer if requested information is missing
Owns intake validation and documentation
Does NOT make compliance or plan decisions
Ensures direction is provided to the Support Team
Provides the secure link for the NMSN

Enrollment Team (QLE Manager/Team)

If all information is provided on the CCR, provides the secure link for the NMSN
If there is missing information on the CCR, loops in the CSM
Does NOT make compliance or plan decisions
Executes enrollment
Adds anonymous data when needed
Handles carrier coordination
Finalizes and confirms completion