Form CCFC186 – Addendum to Parenting Plan Part B Vision Insurance Mother: Case Information 1. Vision Insurance Case Number Father: County Exhibit Number You must check at least one of the following three boxes. Neither party is required to maintain vision insurance for the benefit of the children. A vision benefit plan is not available at reasonable cost through either parent’s employer or union. No support rights have been assigned to the state of Missouri and the Family Support Division is not providing support enforcement services to either party. Father shall maintain and pay the cost of vision insurance with comparable or better benefits at comparable or reduced cost to that now in effect for the benefit of the children. If no vision insurance is now if effect, then Father shall obtain vision insurance if it is available at reasonable cost through his employer or union. The current cost of this vision insurance included on Line 6c of Form 14 is _____________ per month. Mother shall maintain and pay the cost of vision insurance with comparable or better benefits at comparable or reduced cost to that now in effect for the benefit of the children. If no vision insurance is now if effect, then Mother shall obtain vision insurance if it is available at reasonable cost through her employer or union. The current cost of this vision insurance included on Line 6c of Form 14 is _____________ per month. Parenting Plan Part B – Support of Children – Vision Insurance Form CCFC186-11/09 American LegalNet, Inc. www.FormsWorkFlow.com