National Medical Support Notice (NMSN)
The National Medical Support Notice form is used by all child support enforcement agencies to notify employers that one of their employees has been ordered to provide insurance coverage for a dependent. The NMSN has the same authority as a court order related to a dependent’s health insurance coverage.
What is the National Medical Support Notice (NMSN)?
The NMSN is a two-part form that must be completed by an employer when they receive notice from a child support enforcement agency that an individual must cover an eligible minor under their health insurance. Part A of the notice will have been completed by the issuing child support enforcement agency and the court ruling on the judgment, and applies in cases where the employee doesn’t have access to health insurance. When health insurance is available, Part B will be completed by the issuing child support enforcement agency and the court. There is also a portion that must be completed by the employer’s health plan administrator.
Why is the National Medical Support Notice important to my business?
Because this process is associated with a court proceeding and judgment, it becomes a matter of legal record. Failure to comply with the court order will not only reflect poorly on the affected employee but also on your business. Reputational risk isn’t your only concern — you may be subject to sanctions if your company does not respond to the NMSN within 40 days of its effective date. The employer or plan administrator can be penalized up to $200,000 per impacted child per month as a result of a filing from the State’s Attorney. It is also the company’s or plan administrator’s responsibility to notify the issuing agency of an employee’s termination or layoff within 7 days of the event.
What is the history of the NMSN?
This is not a new requirement. Its initial origins can be traced back to 1908 and the medical support provisions of the Omnibus Budget Reconciliation Act (OBRA). In more recent history, Section 382 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) added language requiring a provision for health care coverage in all child support orders established or enforced by IV-D agencies. Although the legislation went through several iterations, it was effective as of January 26, 2001, implementing provisions of the Child Support Performance and Incentives Act of 1998 (CSPIA). The Working Group for this legislation included thirty members representing:
- Employers (including payroll professionals)
- HHS and DOL
- Organizations representing children potentially eligible for medical support
- Organizations representing state child support programs
- Sponsors and administrators of group health plans (as defined in section 607(1) of ERISA)
- State child support directors
- State Medicaid directors
- State medical child support programs
This legislation placed the NMSN under the oversight of the Department of Labor and Health and Human Services.
Summary
The National Medical Support Notice is a process initiated by Health and Human Services agencies responsible for child protection. It is specifically related to health insurance coverage for eligible children and may include wage garnishments. The form addresses situations both where the employee has access to health insurance and where they do not. By completing and enforcing the actions required by these forms, your company participates in the protection and support of children while also ensuring the limits and protections of the Consumer Credit Protection Act (CCPA) are upheld.
