Insurance Premium and Child Care Adjustment Worksheet

Insurance Adjustment

Use this section of the worksheet to calculate how the children's medical insurance premium expenses charge the amount the obligor pays to the obligee.

If the OBLIGOR parent is ordered to maintain medical insurance for the children complete this section.

A. Enter the amount of the children's portion of the medical insurance premium actually paid by the obligor.

$

B. Multiply Line A. by .50 to obtain the obligee's share of the premium.

$

C. Subtract the amount in Line B. from the base child support award to obtain the amount the obligor pays to the obligee for the months the premium is actually paid. Enter the result here.

$

If the OBLIGEE parent is ordered to maintain medical insurance for the children complete this section.

D. Enter the amount of the children's portion of the medical insurance premium actually paid by the obligee.

$

E. Multiply Line D. by .50 to obtain the obligor's share of the premium.

$

F. Add the amount in Line E. to the base child support award to obtain the amount the obligor pays to the obligee for the months the premium is actually paid. Enter the result here.

$

No credit or offset is allowed unless the premium is actually paid. If the premium is not paid, the obligor must pay the amount of the base child support award.

Child Care Adjustment

Use this section of the worksheet to calculate how the children's day care expenses change the amount the obligor pays to the obligee.

G. Enter the average amount of the monthly child care expense actually paid by the obligee.

$

H. Multiply Line G. by .50 to obtain the obligor's share of the child care expense. Enter the result here. Complete box I., J., or K. below

$

I. If neither parent is maintaining insurance, add the amount in Line H. to the base child support award to obtain the amount the obligor pays to the obligee for the months the child care expense is incurred. Enter the result here.

$

J. If the obligor is maintaining insurance, add the amount in Line H. to the amount in Line C. to obtain the amount the obligor pays to the obligee for the months the child care expense is incurred. Enter the result here.

$

K. If the obligee is maintaining insurance, add the amount in Line H. to the amount in Line F. to obtain the amount the obligor pays to the obligee for the months the child care expense is incurred. Enter the result here.

$