We rec'd a MCSO but the noncustodial parent is our 'ee and not enrolled in our health plan. The insurer says it will not enroll the child only, but the MCSO does not say that the 'ee must enroll in the health plan. What are we supposed to do in this situation?

You could determine that the MCO is not qualified because it requires the plan to provide a type or form of benefit or option not otherwise provided under the plan (enrollment of a child when the parent is not enrolled). See ERISA section 609(a)(4).

But try to figure out how to reconcile this with section 609(a)(2)(A)(i), which implies that the alternate recipient can be given the employee's rights to benefits. In your case, if the employee must pay premiums to get the coverage, you can still disqualify the order because the plan can't be forced to cover someone without payment of required premiums. But the order, or a related order could require the employee's pay to be docked for the premium. This is disguised in section 609(a)(2)(b)(ii). I think most states have laws that allow the authorities to order payroll deduction for the child's coverage.

Still perplexed? It is a poorly written law, thoughtlessly copied from the QDRO statute.