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FL-478-INFOOptional

Information Sheet and Instructions for Request and Notice of Hearing Regarding Health Insurance Assignment

California · Judicial Council of California · Effective January 1, 2007

This form provides instructions for asking the court to hold a hearing about a health insurance assignment. It helps people understand how to ask the judge to change or stop an existing order for health insurance coverage for children.

The court describes it as: Explains how to ask the judge to change or stop an order for health insurance coverage for the children.

Open the official PDFfrom Judicial Council of California

Where this fits in a case

Hearing

Stage: Hearing

This form is used when a person needs to object to an Application and Order for Health Insurance Coverage or National Medical Support Notice. It must be filed within 15 days of receiving the notice from an employer, unless the request is to change an existing assignment.

Either party may file.

Common questions

Does this form change my support amount?
The form notes that it will not change your current support amount; it is only used to request a hearing.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect January 1, 2007.

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