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Used when both parties agree on the amount owed for unreimbursed medical expenses, a payment plan, and both parties will sign the documents. (d) The actual cost to provide health-care coverage for the child or children shall be added to the "basic child-support obligation" and shall be divided.Evidence. Jurisdiction over alleged parent. Income and Expense Declaration. Once service was completed, a. The marriage or RDP is legally dissolved as of the date this Judgment is signed. The terms of this judgment are effective upon entry in the court register. Assistance through the AHCCCS (Arizona Health Care Cost Containment. Variance for child care expenses. A (1)(c) Unreimbursed Health Expenses-.