Managing health care costs, especially when it comes to children, can quickly become complicated and contentious between parents. This is precisely why the FL-192 form, otherwise known as the Notice of Rights and Responsibilities concerning Health-Care Costs and Reimbursement Procedures, is crucial for parents with a child support order that includes a provision for the reimbursement of health-care costs not covered by insurance. This form lays out essential guidelines and responsibilities for both parents, ensuring that uninsured health-care costs are adequately communicated, shared, and disputed when necessary. It provides a clear procedure for issuing notice of incurred health-care costs, submitting proof of payment, and handling disputes over charges. Moreover, the form details the obligations concerning court-ordered health insurance and the steps required if modifications to child support orders related to health-care costs are needed. By clarifying these processes, the FL-192 form aims to minimize conflicts and misunderstandings between separated or divorced parents, making the management of child health-care costs more transparent and equitable. Additionally, it includes provisions for the use of preferred health providers and outlines the financial responsibilities should parents choose alternative or additional coverage, crucially impacting how parents navigate health-care decisions for their children within the framework of child support.
| Question | Answer |
|---|---|
| Form Name | Fl 192 Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | ca fl192, california health reimbursement procedures, fl 192 notice rights responsibilities, fl 192 form |
NOTICE OF RIGHTS AND RESPONSIBILITIES
IF YOU HAVE A CHILD SUPPORT ORDER THAT INCLUDES A PROVISION FOR THE
REIMBURSEMENT OF A PORTION OF THE CHILD'S OR CHILDREN'S
AND THOSE COSTS ARE NOT PAID BY INSURANCE, THE LAW SAYS:
1. Notice. You must give the other parent an itemized |
7. Preferred health providers. If the |
statement of the charges that have been billed for any health- |
designates a preferred |
care costs not paid by insurance. You must give this |
must be used at all times consistent with the terms of the |
statement to the other parent within a reasonable time, but no |
health insurance policy. When any party uses a |
more than 30 days after those costs were given to you. |
provider other than the preferred provider, any |
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costs that would have been paid by the preferred health |
2. Proof of full payment. If you have already paid all of the |
provider if that provider had been used must be the sole |
uninsured costs, you must (1) give the other parent proof that |
responsibility of the party incurring those costs. |
you paid them and (2) ask for reimbursement for the other |
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parent's |
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3.Proof of partial payment. If you have paid only your share of the uninsured costs, you must (1) give the other parent proof that you paid your share, (2) ask that the other parent pay his or her share of the costs directly to the
4.Payment by notified parent. If you receive notice from a parent that an uninsured
(4) according to a schedule adopted by the court.
5.Disputed charges. If you dispute a charge, you may file a motion in court to resolve the dispute, but only if you pay that charge before filing your motion. If you claim that the other party has failed to reimburse you for a payment, or the other party has failed to make a payment to the provider after proper notice has been given, you may file a motion in court to resolve the dispute. The court will presume that if uninsured costs have been paid, those costs were reasonable. The court may award attorney fees and costs against a party who has been unreasonable.
6.
a.Burden to prove. The party claiming that the coverage is inadequate to meet the child's needs has the burden of proving that to the court.
b.Cost of additional coverage. If a parent purchases health- care insurance in addition to that ordered by the court, that parent must pay all the costs of the additional coverage. In addition, if a parent uses alternative coverage that costs more than the coverage provided by court order, that parent must pay the difference.
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Form Approved for Optional Use |
NOTICE OF RIGHTS AND RESPONSIBILITIES |
Family Code, §§ 4062, 4063 |
Judicial Council of California |
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INFORMATION SHEET ON CHANGING A CHILD SUPPORT ORDER
General Information
The court has just made a child support order in your case. This order will remain the same unless a party to the action requests that the support be changed (modified). An order for child support can be modified only by filing a motion to change child support and serving each party involved in your case. If both parents and the local child support agency (if it is involved) agree on a new child support amount, you can complete, have all parties sign, and file with the court a Stipulation to Establish or Modify Child Support and
Order ( |
) or Stipulation and Order (Governmental) ( |
). |
When a Child Support Order May Be Modified
The court takes several things into account when ordering the payment of child support. First, the number of children is considered. Next, the net incomes of both parents are determined, along with the percentage of time each parent has physical custody of the children. The court considers both parties’ tax filing status and may consider hardships, such as a child of another relationship. An existing order for child support may be modified when the net income of one of the parents changes significantly, the parenting schedule changes significantly, or a new child is born.
Examples
•You have been ordered to pay $500 per month in child support. You lose your job. You will continue to owe $500 per month, plus 10 percent interest on any unpaid support, unless you file a motion to modify your child support to a lower amount and the court orders a reduction.
•You are currently receiving $300 per month in child support from the other parent, whose net income has just increased substantially. You will continue to receive $300 per month unless you file a motion to modify your child support to a higher amount and the court orders an increase.
•You are paying child support based upon having physical custody of your children 30 percent of the time. After several months it turns out that you actually have physical custody of the children 50 percent of the time. You may file a motion to modify child support to a lower amount.
How to Change a Child Support Order
To change a child support order, you must file papers with the court. Remember: You must follow the order you have now.
What forms do I need?
If you are asking to change a child support order, you must fill out one of these forms:
•, Request for Order OR
•, Notice of Motion and Motion for Simplified Modification of Order for Child, Spousal, or Family Support
You must also fill out one of these forms:
•, Income and Expense Declaration OR
•, Financial Statement (Simplified)
What if I am not sure which forms to fill out?
Talk to the family law facilitator at your court.
After you fill out the forms, file them with the court clerk and ask for a hearing date. Write the hearing date on the form. The clerk may ask you to pay a filing fee. If you cannot afford the fee, fill out these forms, too:
•, Request to Waive Court Fees
•, Order on Court Fee Waiver (Superior Court)
You must serve the other parent. If the local child support agency is involved, serve it too.
This means someone 18 or
all days of the month, including weekends and holidays. To find court holidays, go to |
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The server must also serve blank copies of these forms: |
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, Responsive Declaration to Request for Order AND |
, Income and Expense Declaration,OR |
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•, Financial Statement (Simplified)
Then the server fills out and signs a Proof of Service ( or ). Take this form to the clerk and file it.
Go to your hearing and ask the judge to change the support. Bring your tax returns from the last two years and your last two months' pay stubs. The judge will look at your information, listen to both parents, and make an order. After the hearing, fill out:
•, Findings and Order After Hearing AND
•, Child Support Information and Order Attachment
Need help? |
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Contact the |
in your county or call your county's bar association and ask for an experienced family lawyer. |
NOTICE OF RIGHTS AND RESPONSIBILITIES
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