§ 416. Elements of support; provisions for accident, life and health
insurance benefits. (a) The court may include in the requirements for an
order for support the providing of necessary shelter, food, clothing,
care, medical attention, expenses of confinement, the expense of
education, payment of funeral expenses, and other proper and reasonable
expenses.

(b) The court may also order a party to purchase, maintain, or assign
a policy of accident insurance or insurance on the life of either party
and designate in the case of life insurance, the person or persons on
whose behalf the petition is brought or in the case of accident
insurance, the insured party as irrevocable beneficiaries during a
period of time fixed by the court. The obligation to provide such
insurance shall cease upon the termination of such party's duty to
provide support.

(c) Every support order shall provide that if any legally responsible
relative currently, or at any time in the future, has health insurance
benefits available that may be extended or obtained to cover any person
on whose behalf the petition is brought, such responsible relative is
required to exercise the option of additional coverage in favor of such
person whom he or she is legally responsible to support and to execute
and deliver to such person any forms, notices, documents, or instruments
to assure timely payment of any health insurance claims for such person.

(d) As used in this section, the following terms shall have the
following meanings: (1) "Health insurance benefits" means any medical,
dental, optical and prescription drugs and health care services or other
health care benefits that may be provided for a dependent through an
employer or organization, including such employers or organizations
which are self insured, or through other available health insurance or
health care coverage plans.

(2) "Available health insurance benefits" means any health insurance
benefits that are reasonable in cost and that are reasonably accessible
to the person on whose behalf the petition is brought. Health insurance
benefits that are not reasonable in cost or whose services are not
reasonably accessible to such person shall be considered unavailable.

(3) When the person on whose behalf the petition is brought is a child
in accordance with subdivision (e) of this section, health insurance
benefits shall be considered "reasonable in cost" if the cost of health
insurance benefits does not exceed five percent of the combined parental
gross income. The cost of health insurance benefits shall refer to the
cost of the premium and deductible attributable to adding the child or
children to existing coverage or the difference between such costs for
self-only and family coverage. Provided, however, the presumption that
the health insurance benefits are reasonable in cost may be rebutted
upon a finding that the cost is unjust or inappropriate which finding
shall be based on the circumstances of the case, the cost and
comprehensiveness of the health insurance benefits for which the child
or children may otherwise be eligible, and the best interests of the
child or children. In no instance shall health insurance benefits be
considered "reasonable in cost" if a parent's share of the cost of
extending such coverage would reduce the income of that parent below the
self-support reserve. Health insurance benefits are "reasonably
accessible" if the child lives within the geographic area covered by the
plan or lives within thirty minutes or thirty miles of travel time from
the child's residence to the services covered by the health insurance
benefits or through benefits provided under a reciprocal agreement;
provided, however, this presumption may be rebutted for good cause shown
including, but not limited to, the special health needs of the child.
The court shall set forth such finding and the reasons therefor in the
order of support.

(e) When the person on whose behalf the petition is brought is a
child, the court shall consider the availability of health insurance
benefits to all parties and shall take the following action to insure
that health insurance benefits are provided for the benefit of the
child:

(1) Where the child is presently covered by health insurance benefits,
the court shall direct in the order of support that such coverage be
maintained, unless either parent requests the court to make a direction
for health insurance benefits coverage pursuant to paragraph two of this
subdivision.

(2) Where the child is not presently covered by health insurance
benefits, the court shall make its determination as follows:

(i) If only one parent has available health insurance benefits, the
court shall direct in the order of support that such parent provide
health insurance benefits.

(ii) If both parents have available health insurance benefits the
court shall direct in the order of support that either parent or both
parents provide such health insurance. The court shall make such
determination based on the circumstances of the case, including, but not
limited to, the cost and comprehensiveness of the respective health
insurance benefits and the best interests of the child.

(iii) If neither parent has available health insurance benefits, the
court shall direct in the order of support that the custodial parent
apply for the state's child health insurance plan pursuant to title
one-A of article twenty-five of the public health law and the medical
assistance program established pursuant to title eleven of article five
of the social services law. A direction issued under this subdivision
shall not limit or alter either parent's obligation to obtain health
insurance benefits at such time as they become available as required
pursuant to subdivision (c) of this section. Nothing in this subdivision
shall alter or limit the authority of the medical assistance program to
determine when it is considered cost effective to require a custodial
parent to enroll a child in an available group health insurance plan
pursuant to paragraphs (b) and (c) of subdivision one of section three
hundred sixty-seven-a of the social services law.

(f) The cost of providing health insurance benefits or benefits under
the state's child health insurance plan or the medical assistance
program, pursuant to subdivision (e) of this section, shall be deemed
cash medical support, and the court shall determine the obligation of
either or both parents to contribute to the cost thereof pursuant to
subparagraph five of paragraph (c) of subdivision one of section four
hundred thirteen of this part.

(g) The court shall provide in the order of support that the legally
responsible relative immediately notify the other party, or the other
party and the support collection unit when the order is issued on behalf
of a child in receipt of public assistance and care or in receipt of
services pursuant to section one hundred eleven-g of the social services
law, of any change in health insurance benefits, including any
termination of benefits, change in the health insurance benefit carrier,
premium, or extent and availability of existing or new benefits.

(h) Where the court determines that health insurance benefits are
available, the court shall provide in the order of support that the
legally responsible relative immediately enroll the eligible dependents
named in the order who are otherwise eligible for such benefits without
regard to any seasonal enrollment restrictions. The support order shall
further direct the legally responsible relative to maintain such
benefits as long as they remain available to such relative. Such order
shall further direct the legally responsible relative to assign all
insurance reimbursement payments for health care expenses incurred for
his or her eligible dependents to the provider of such services or the
party actually having incurred and satisfied such expenses, as
appropriate.

(i) When the court issues an order of child support or combined child
and spousal support on behalf of persons in receipt of public assistance
and care or in receipt of services pursuant to section one hundred
eleven-g of the social services law, such order shall further direct
that the provision of health care benefits shall be immediately enforced
pursuant to section fifty-two hundred forty-one of the civil practice
law and rules.

(j) When the court issues an order of child support or combined child
and spousal support on behalf of persons other than those in receipt of
public assistance and care or in receipt of services pursuant to section
one hundred eleven-g of the social services law, the court shall also
issue a separate order which shall include the necessary direction to
ensure the order's characterization as a qualified medical child support
order as defined by section six hundred nine of the employee retirement
income security act of 1974 (29 USC 1169). Such order shall: (i) clearly
state that it creates or recognizes the existence of the right of the
named dependent to be enrolled and to receive benefits for which the
legally responsible relative is eligible under the available group
health plans, and shall clearly specify the name, social security number
and mailing address of the legally responsible relative, and of each
dependent to be covered by the order; (ii) provide a clear description
of the type of coverage to be provided by the group health plan to each
such dependent or the manner in which the type of coverage is to be
determined; and (iii) specify the period of time to which the order
applies. The court shall not require the group health plan to provide
any type or form of benefit or option not otherwise provided under the
group health plan except to the extent necessary to meet the
requirements of a law relating to medical child support described in
section one thousand three hundred and ninety-six g-1 of title forty-two
of the United States code.

(k) Upon a finding that a legally responsible relative wilfully failed
to obtain health insurance benefits in violation of a court order, such
relative will be presumptively liable for all health care expenses
incurred on behalf of such dependents from the first date such
dependents were eligible to be enrolled to receive health insurance
benefits after the issuance of the order of support directing the
acquisition of such coverage.