F.A.Q.
1. What is the National Medical Support Notice?
2. When is the NMSN sent to employers?
3. Are employers and health plan administrators required to comply?
4. What is included in the NMSN?
5. Who completes Part A of the NMSN?
6. Who completes Part B of the NMSN?
7. How soon must both parts of the Notice be completed?
8. What if the employee doesn't make enough to cover the regular child support amount and the medical coverage premiums?
9. What if the employee doesn't want to enroll the child for medical coverage?
10. What if the employer gets more than one NMSN for the same employee?
11. What can the employee do if the employee believes that a NMSN has been issued in error?
12. Who may the employer or plan administrator contact with questions about the NMSN?

 

1. What is the National Medical Support Notice?

The National Medical Support Notice (NMSN) is a new, two-part federally-required form. It was designed to provide employers and plan administrators with a standardized set of forms, processes, and timeframes to streamline the work to enroll dependent children in employer-sponsored health care plans. The NMSN meets the requirements for a Qualified Medical Child Support Order (QMCSO) if the child support agency correctly completes it and if coverage for the child(ren) is or will become available. The NMSN is a QMCSO under the Employee Retirement Income Security Act (ERISA) section 609 (a)(5)(s).

 

2. When is the NMSN sent to employers?

The NMSN will typically be issued a few days following your receipt of an Order/Notice to Withhold Income for Child Support.

 

3. Are employers and health plan administrators required to comply?

Yes. Employers and plan administrators who fail to comply with the NMSN in a timely manner may be subject to court actions by either the State or the parents of the dependent(s).

 

4. What is included in the NMSN?

Part A of the NMSN includes an Employer Information Sheet, the Notice to Withhold for Health Care Coverage, the Employer Response form, and the Instructions.

Part B includes a Medical Support Notice to Plan Administrator, the Plan Administrator Response form, the NMSN Insurance Coverage Information Sheet, and the Instructions.

 

5. Who completes Part A of the NMSN?

Part A – Notice to Withhold For Health Care Coverage informs the employer of the type of coverage required under the order and the terms of coverage. The employer should complete and return Part A to the NMSN Processing Center only if the following federally-mandated conditions for non-coverage exists:

  1. The employee named in the NMSN has never been employed by this employer.
  2. We, the employer, do not maintain or contribute to plans providing dependent or family health care coverage to our employees.
  3. The employee is among a class of employees (for example, part-time or non-union) that are not eligible for family health coverage under any group health plan maintained by the employer or to which the employer contributes.
  4. Health care coverage is not available because the employee is no longer employed by this employer.
  5. State or Federal withholding limitations and/or prioritization prevent the withholding from the employee’s income of the amount required to obtain coverage under the terms the plan. If multiple coverage options are available to the employee and some of the options would result in a violation of State or Federal withholding limitations, the employer must advise the Plan Administrator to enroll the dependent(s) in the option that is within allowable limits.
  6. If one of these five conditions is not met, the employee’s dependent(s) must be enrolled in the employer-provided health care plan.

 

6. Who completes Part B of the NMSN?

Part B – Medical Support Notice to Plan Administrator applies if the dependent is eligible for coverage. The NMSN is forwarded to the insurance Plan Administrator who has 40 days from the date of the Notice to complete and return to the NMSN Processing Center at PO Box 4655 , Trenton, NJ 08650. The Plan Administrator must also notify the employer's payroll department of enrollment so that premiums are deducted, and forward insurance cards and plan information to the custodial parent identified on Part B of the NMSN.

 

7. How soon must both parts of the Notice be completed?

Within 20 days of the NMSN:

  • The employer must complete Part A and either forward Part B to the Plan Administrator or return Part A to the NMSN Processing Center.

Within 40 days of the issue date of the NMSN, the Plan Administrator must:

  • Complete and return Part B to the NMSN Processing Center.
  • Advise the employer to begin withholding.
  • Forward the insurance cards and plan information to the custodial parent identified on Part B of the NMSN.

 

8. What if the employee doesn't make enough to cover the regular child support amount and the medical coverage premiums?

The employer should check box 5 of the Employer Response (Part A), complete the Employer Information Sheet, and return both to the NMSN Processing Center. If multiple coverage options are available to the employee and some of the options would result in a violation of State or Federal withholding limitations, the employer must advise the Plan Administrator to enroll the dependent(s) in the option that is within allowable limits.

 

9. What if the employee doesn't want to enroll the child for medical coverage?

The employee does not have a choice. The NMSN is a Qualified Medical Child Support Order (QMCSO). If none of the five conditions on the Part A – Employer Response form applies, the Plan Administrator is required to enroll the child(ren) as instructed by the Notice. If the employee has a dispute with the enforcement of the QMCSO, the employee should be directed to contact their local enforcement office. The employer must still comply with the NMSN regardless of whether an objection has been made.

 

10. What if the employer gets more than one NMSN for the same employee?

Determining the best way to handle multiple orders can sometimes be complicated. If the employer has specific questions in regards to the Notice, the employer may contact the NMSN Processing Center at (800) 806-3621.

 

11. What can the employee do if the employee believes that a NMSN has been issued in error?

The employee may contact the local enforcement office to discuss the matter. However, the employer must continue to comply with the employer responsibilities under the NMSN until notified to discontinue withholding.

 

12. Who may the employer or plan administrator contact with questions about the NMSN?

Employers and plan administrators may contact the NMSN Processing Center at (800) 806-3621.


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