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Distribution of Federally Approved National Medical Support Notice

AT-11-03

Published: March 29, 2011
Information About:
State/Local Child Support Agencies, Employers
Topics:
Case Management, Medical Support, Employer Responsibilities, National Medical Support Notice
Types:
Policy, Action Transmittals (AT)

ACTION TRANSMITTAL

AT-11-03

DATE: March 29, 2011

TO: State Agencies Administering Child Support Enforcement Plans under Title IV-D of the Social Security Act and Other Interested Individuals

Subject: Distribution of Federally Approved National Medical Support Notice

Attachments: National Medical Support Notice (NMSN) Part A, OMB control number 0970-0222 and NMSN Part B, OMB control number 1210-0113

Statutory Reference: 45 CFR 303.32 and 29 CFR 2590.609.2. The final rule, effective January 26, 2001, implemented provisions of the Child Support Performance and Incentive Act of 1998, Public Law 105-200. These provisions require State Child Support Enforcement (CSE) agencies, under title IV-D of the Social Security Act, to enforce the health care coverage provision in a child support order and to use the NMSN to aid enforcement. Tribal IV-D agencies are not required to use these forms.

Background: Attached are the NMSN Parts A and B. At present, the NMSN Part B has no changes. However, the Department of Labor will make conforming changes to Part B in the near future. The Federal Office of Child Support Enforcement (OCSE) solicited comments from the CSE community on the NMSN Part A. OCSE updated the NMSN Part A to reflect the suggestions received from states. The new OMB expiration date is March 31, 2014.

Based on the comments received, OCSE made the following changes to the NMSN Part A.

GENERAL CHANGES

  • At the bottom of each page, added the page number.
  • At the bottom of page 1, added the new expiration date: 03/31/2014.
  • On page 1, in the Header paragraph, changed the word “noncustodial parent” to “employee” in the third sentence. Since both the noncustodial parent and/or the custodial parent (at state option) can be ordered to provide medical support, “noncustodial parent” was changed to “employee”. The third sentence now reads: “The information on the Custodial Parent and Child(ren) contained on this page is confidential and should not be shared or disclosed with the employee.”
  • On page 1, in the Header paragraph, clarified instructions with regard to the term “employee” by adding a final sentence that reads: “NOTE: For purposes of this form, the Custodial Parent may also be the employee when the State opts to enforce against the Custodial Parent.” When this occurs, the information on the custodial parent can be shared with the employee since it is the same person.
  • Revised the NMSN so that the data fields are arranged with all information completed by the issuing agency on pages 1 and 2, all information completed by the employer on page 3, and standard instructions to the employer on pages 4 and 5.

ADDITIONAL CHANGES

The following changes were made to standardize the data fields on OCSE forms.

Pages 1 – 2: Completed by Issuing Agency

  • Changed the data field from “Date of Notice” to “Notice Date”.
  • Changed the data field from “Case Number” to “CSE Agency Case Identifier”. CSE Agency Case Identifier is a unique identifier assigned to a state or tribal CSE case. In a state CSE case, this is the identifier that is reported to the Federal Case Registry.
  • Changed the data field from “Date of Support Order” to “Order Date”.
  • Added data field for the “Order Identifier”. Order Identifier is a unique identifier that is associated with a specific child support obligation. It could be a court case number, docket number, or other identifier designated by the issuing agency.
  • Added data field for the “Document Tracking Identifier”. Document Tracking Identifier is an optional unique identifier for this form assigned by the issuing agency.

The following changes were made to provide a standard set of instructions to employers.

Pages 1 – 2: Completed by Issuing Agency

  • Moved “Limitations on Withholding” information to page 2, the page completed by the issuing agency.
  • Moved “Priority for Withholding” information to page 2, the page completed by the issuing agency.

Page 3: Completed by Employer

  • Moved “Contact for Questions” information to page 3, the page completed by the employer.

The following changes were made to gather all information necessary to enroll the child(ren) in health coverage, to provide clear instructions for completing the employer response section, and to make the form more user-friendly.

Pages 1 – 2: Completed by Issuing Agency

  • In the agency information box, added data field “See NMSN Instructions: www.acf.hhs.gov/ programs/cse/forms/.” This link was added for employers to access the NMSN instructions electronically. The agency must continue to mail the hard copy of the instructions with each NMSN unless the employer has requested otherwise, see OCSE PIQ-02-03.
  • Added additional space for: substituted official/agency name and address, and the representative of the child(ren) name, telephone number, and mailing address.
  • In the section where the child(ren)’s name(s) are listed, added a column to include the child(ren)’s gender.
  • In the section where the order identifies the coverage for the children, changed the word “any” to “all”. The new sentence now reads, “The order requires the child(ren) to be enrolled in all health coverages available;” The purpose of the sentence is to clarify which type of health coverage the child(ren) must be enrolled in, i.e., all health coverages available or only the selected coverages.
  • In the section where the order identifies the coverage for the children, added check boxes.

Page 3: Completed by Employer

  • In the Employer Response section, in the Header paragraph:
    • Revised sentence 1 to read: “If 1, 2, 3, 4 or 5 below applies, check the appropriate box and return this Part A to the Issuing Agency within 20 business days after the date of the Notice, or sooner if reasonable.
    • Revised sentence 3 to read: “If 1 through 5 does not apply, complete item 7 and forward Part B to the appropriate Plan Administrator(s) within 20 business days after the date of the Notice, or sooner if reasonable.“
    • Revised the last sentence to read: “Information for the Plan Administrator and the Employer Representative at the bottom of this section is required.”
  • In the Employer Response section, revised check box # 2 to read: “We, the employer, do not offer our employees the option of purchasing dependent or family health care coverage as a benefit of their employment.” This change was made to clarify for employers that the issuing agency needs to know when the employer does not offer group health insurance coverage to any employee, regardless of whether the employer contributes a dollar amount towards the premium cost.
  • In the Employer Response section, added check box # 6 to read: “The participant is subject to a waiting period that expires _________ (more than 90 days from the date of receipt of this Notice), or has not completed a waiting period, which is determined by some measure other than the passage of time, such as the completion of a certain number of hours worked (describe here:__________). At the completion of the waiting period, the Plan Administrator will process the enrollment.” This sentence was added to inform the issuing agency that the participant will be eligible for coverage subject to a waiting period that exceeds 90 days, similar to check box #4 on the NMSN Part B.
  • In the Employer Response section, added check box # 7 to read: “Employer forwarded Part B to Plan Administrator on ________.” This was added to inform MM/DD/YY the issuing agency that the NMSN Part B was forwarded to the Plan Administrator within the required time frame.

Pages 4 – 5: Instructions to Employer

  • In the Instructions to Employer section, deleted “if appropriate” from the first sentence of the third paragraph. The sentence now reads: “An employer receiving this legal Notice is required to complete and return Part A.”
  • In the Instructions to Employer section, deleted “at anytime in the future” from the fourth paragraph. The sentence now reads: “Keep a copy of Part A as it may be used to notify the Issuing Agency if the employee separates from service for any reason including retirement or termination.”
  • In the Instructions to Employer section, within the “Employer Responsibilities” added “5” to sentence 1. The sentence now reads: “If the individual named in this Notice is not your employee, or if the family health care coverage is not available, please complete item 1, 2, 3, 4 or 5 of the Employer Response as appropriate, and return it to the Issuing Agency. NO OTHER ACTION IS NECESSARY.”
  • In the Instructions to Employer section, within the “Employer Responsibilities” added “complete item 7” to sentence 2a. The sentence now reads: “Transfer, not later than 20 business days after the date of this Notice, a copy of Part B - Medical Support Notice to the Plan Administrator to the Administrator of each appropriate group health plan for which the child(ren) may be eligible, complete item 7, and…”
  • In the Instructions to Employer section, within the “Employer Responsibilities” added “complete item 6 of the Employer Response to” to sentence 2c. The sentence now reads: “If the Plan Administrator notifies you that the employee is subject to a waiting period that expires more than 90 days from the date of its receipt of Part B of this Notice, or whose duration is determined by a measure other than the passage of time (for example, the completion of a certain number of hours worked), complete item 6 of the Employer Response to notify the Issuing Agency of the enrollment timeframe and notify the Plan Administrator when the employee is eligible to enroll in the plan and that this Notice requires the enrollment of the child(ren) named in the Notice in the plan.”
  • In the Instructions to Employer section, within the “Contact for Questions” changed the word “at” to “on”. The sentence now reads: “If you have any questions regarding this Notice, you may contact the Issuing Agency at the address and telephone number listed on page 1 of this Notice.”

SUPERSEDED MATERIAL: AT-05-05, AT-08-05

ACTION REQUIRED: States will need time to make system programming changes to automate the new form. Therefore, please continue to honor the previous form until states are able to implement the revised one. The NMSN Parts A and B are available on our website.

INQUIRIES TO: ACF/OCSE Regional Program Managers

Sincerely,

Vicki Turetsky
Commissioner
Office of Child Support Enforcement

cc: ACF/OCSE Regional Program Managers
Tribal IV-D Agencies