Medical support is a form of child support that provides either cash medical support or health insurance. Cash medical support is ordered on the Income Withholding Order for Support (IWO) order/notice. Child support agencies send a National Medical Support Notice (NMSN) to the employer to order health insurance coverage for an employee’s child(ren).
For more information, see Medical Support for Employers.
Remember that the Consumer Credit Protection Act (CCPA) limits apply and that if there is insufficient allowable disposable income to withhold the amount ordered plus health insurance, you must check the law of your employee’s work state for priorities of different types of child support. Priorities and CCPA limits for every state are available in the income withholding matrix.
To help understand the above steps, please see the NMSN process flowchart.
Using the NMSN as a health coverage termination order or notice is optional for child support agencies. If you receive an NMSN with the termination box checked at top, you may terminate the coverage for named children unless the employee voluntarily wishes to continue the coverage.
For additional information, check out these questions and answers about medical support and the matrix of state-specific contacts and requirements for employers.
An appropriately completed NMSN is considered a QMCSO and must be honored by all employers’ group health plans. A QMCSO must clearly specify:
For more information on QMCSOs, please see the Compliance Guide for Qualified Medical Child Support Orders.
Child support agencies send a National Medical Support Notice (NMSN) to the employer to order health insurance coverage for an employee’s child(ren). Employers must honor this notice.