40-5-804. Definitions. For purposes of this part, the following definitions apply:

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(1)”Child” means an individual, whether over or under 18 years of age, to whom or on whose behalf a legal duty of support is owed by a parent. The term includes but is not limited to a child enrolled or eligible for enrollment under a health benefit plan or individual insurance policy.

(2)”Child support guidelines” means guidelines adopted under the provisions of 40-5-209.

(3)”COBRA” means the federal Consolidated Omnibus Budget Reconciliation Act of 1985, under which dependent children of employees may continue to receive, for a limited time under specific circumstances, health plan coverage after termination of employment.

(4)”Department” means the department of public health and human services as provided for in 2-15-2201.

(5)(a) “Health benefit plan” or “plan” means a group health benefit plan or combination of plans that provides medical care or benefits for a child. The term includes but is not limited to a health maintenance organization, self-funded group, state or local government group health plan, church group plan, medical or health service corporation, or similar plan.

(b)The term does not include public health coverage if other medical insurance is available to one or both of the parents at a reasonable cost and is accessible for the child.

(6)”Individual insurance” means health or medical insurance coverage other than a group health benefit plan or public assistance that is or may be provided individually for a child.

(7)”Medical care” means diagnosis, cure, mitigation, treatment, or prevention of disease, illness, or injury, including well baby checkups, periodic examinations, and any other undertaking for the purpose of affecting any structure or function of the body.

(8)”Medical support order” means a judgment, decree, or order, including approval of a settlement agreement issued by a tribunal of competent jurisdiction, that provides for the medical care of a child and that complies with the requirements of this part.

(9)”Obligated parent” means the parent who is required by a medical support order to provide for the medical care of a child. The obligated parent is not necessarily the same as an obligor for child support.

(10)”Parent” means a father or mother and includes a child’s guardian or other adult caretaker having lawful charge of the child.

(11)”Payor” or “payor of income” means a person, firm, corporation, association, union, employer, trustee, political subdivision, state agency, or any agent thereof who pays income to a parent on a periodic basis, who has or provides individual insurance or a health benefit plan, and who is subject to the jurisdiction of this state under Rule 4(b) of the Montana Rules of Civil Procedure or any employer under the Uniform Interstate Family Support Act.

(12)”Plan administrator” means the person or entity, including but not limited to a state or local government or church, that assesses and collects premiums, accepts and processes claims, and pays benefits.

(13)”Primary parent” means the parent with whom the child resides for the most 24-hour periods in a plan year.

(14)”Qualified medical child support order” means an order that meets the requirements of 29 U.S.C. § 1169.

(15)”Third-party custodian” means an agency or person other than a parent who:

(a)is authorized by legal process to have physical custody of a child;

(b)has actual physical custody of a child with the written consent of the parent or parents having legal custody of the child; or

(c)has actual physical custody of a child because of the parents’ neglect, failure, or inability to provide for the child’s support, medical care, and other needs.

(16)”Tribunal” means a court of competent jurisdiction or the department.