Request for Comments on Proposed National Medical Support Notice Form – Part B
DEAR COLLEAGUE LETTER
DATE: December 06, 2010
ATTACHMENT: Draft National Medical Support Notice (NMSN) Form and Instructions – Part B
TO: ALL STATE IV-D DIRECTORS
RE: Request for Comments on Proposed National Medical Support Notice (NMSN) Form – Part B
Title 45 CFR 303.32 and 29 CFR 2590.609.2 implemented provisions of the Child Support Performance and Incentive Act of 1998 (CSPIA), Public Law 105-200. These provisions require state child support agencies, under title IV-D of the Social Security Act, to enforce the health care coverage provision in child support orders, and to use the NMSN to aid enforcement. Tribal child support programs are not required to use this form.
In compliance with the requirements of Section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, the Department of Labor, Employee Benefits Security Administration is soliciting public comments on the renewal of the NMSN – Part B. As of Wednesday, November 10, 2010, a notice for public comment has been posted to the Federal Register. The notice appears on page 69129 in Volume 75, Number 217.>
The need to reauthorize the NMSN provides the opportunity to consider some revisions. These changes are needed in order to ensure the efficient implementation of the electronic NMSN and to conform to the revisions of Part A of the Notice.
GENERAL CHANGES - All Pages
- At the bottom of each page, added the page number.
- Throughout the Notice changed the words “noncustodial parent” and “participant” to “employee”.
NOTICE TO WITHHOLD FOR HEALTH CARE COVERAGE - Page 1
- In the first sentence of the Header Paragraph, added the abbreviation (CSPIA) after “Child Support Performance and Incentive Act of 1998.”
- In the Header Paragraph, clarified instructions with regard to the term “employee” by adding a new fifth sentence in the Header Paragraph 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.”
- In the agency information box, changed the data field from “Date of Notice” to “Notice Date”.
- In the agency information box, changed the data field from “Case Number” to “CSE Agency Case Identifier”.
- In the agency information box, changed the data field from “Date of Support Order” to “Order Date”.
- In the agency information box, added data field for the “Order Identifier”.
- In the agency information box, added data field for the “Document Tracking Number.”
- In the agency information box, added data field “See NMSN Instructions: www.acf.hhs.gov/ programs/ cse/ forms/”
- Added additional space for substituted official/agency name and address.
- Added additional space for name, telephone number, and mailing address of a representative of the child(ren).
- 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;”
- In the section where the order identifies the coverage for the children, added check boxes.
- At the bottom of the page, added the new expiration date: 03/31/2014.
PLAN ADMINISTRATOR'S RESPONSE - Pages 2 - 5
- Response number “1” is now renumbered as response number “2”.
- Response number “2” is now renumbered as response number “5”;
- Response number “3” is now renumbered as response number “4”;
- Response number “4” is now renumbered as response number “3”;
- Response number “5” in now renumbered as response number “1”.
- Under the new response number 1, added check boxes for each option.
- Under the new response number 1, added a table to list each of the child(ren)’s names, gender, and social security number.
- In the new response number 2, in the second sentence, changed “2 or 3, and 4” so it now reads “4 or 5, and 3”.
- Under the new response number 5, added check boxes for each option.
- Under the new response number 5, added data field “Total Number of All Dependents: _____”.
Under the new response number 5, added six sections. Each section is identified as medical insurance, dental insurance, vision insurance, prescription drug insurance, mental health insurance, or other insurance. Each of the added sections has space to include the following information:
- Insurance Provider Name
- NAIC Code
- Insurance Provider address Line 1
- Insurance Provider address Line 2
- Insurance Provider city, state, zip code, and zip code extension
- Group Number
- Renewal Date
- Coverage cost for individual and cost frequency
- Coverage cost for listed children and cost frequency
- A table was added to each of the six sections of insurance coverage described above. Each table includes columns to list the child(ren)’s name, gender, social security number, date of birth, policy number, start date and end date associated with the type of insurance.
INSTRUCTIONS TO THE PLAN ADMINISTRATOR - Pages 6 - 8
- Item (1)(a) changed “if you checked Response 2” so it now reads “if you checked Response 5”.
- Item (1)(b) changed “if you checked Response 3” so it now reads “if you checked Response 4”.
- Item (1)(c) changed “complete Response 4” so it now reads “complete Response 3”.
- Item (1)(c) changed “Response 2 or 3” so it now reads “Response 4 or 5”.
- Item (B), in the first sentence, changed “Response 5 of Part B” so it now reads “Response 1 of Part B”.
If you wish to comment on the form, please follow the instructions for public comment in the Federal Register notice. When commenting, please be sure to reference the OMB number associated with the form, i.e., OMB 1210-0113. Consideration will be given to comments received by Monday, January 10, 2011.
Office of Child Support Enforcement
ACF/OCSE Regional Program Managers
Tribal IV-D Directors