A more thorough explanation:

QMCSO stands for qualified medical child support order. It is a court or state administrative agency order that allows an alternate beneficiary, such as a participant's child or stepchild, to be covered by the participant's group health plan.

Under the Employee Retirement Income Security Act (ERISA), a QMCSO is a medical child support order. This means it is a judgment, order, or decree under state domestic relations law or other relevant state law that provides for child support or health benefits coverage for the child of a group health plan participant.

For a medical child support order to become a QMCSO, it must establish or recognize an alternate beneficiary's right to receive the participant's benefits under the group health plan or assign this right to receive group health plan benefits to an alternate beneficiary.

John has a group health plan through his employer. He has a child from a previous marriage, and his ex-wife has custody of the child. The court issues a medical child support order that requires John to provide health benefits coverage for his child through his group health plan. This order can become a QMCSO if it meets the requirements under ERISA.

This example illustrates how a medical child support order can become a QMCSO if it meets the requirements under ERISA. The QMCSO allows the child to be covered by John's group health plan, even though the child is not a direct participant in the plan.