Medical Support

What Employers Need To Know 

The Child Support Services Division (CSSD) uses the National Medical Support Notice (NMSN) to order health care coverage. The NMSN is a federal form that all state child support agencies must use. The form was developed with input from employer groups and health plan administrators. 

The NMSN is four documents and instructions:

Part A- Notice to Withhold For Health Care Coverage.  This will be completed by the Issuing Agency and sent to the employer with the rest of the packet.

"Employer Response" is your opportunity to respond to the request if one of the following exists:

  1. You do not provide health care coverage for your employees.
  2. The employee is not eligible for the health care coverage you provide.
  3. The employee has been terminated or has left this employment.
  4. The deduction for health care coverage cannot be made because of withholding limits and the State's priority for withholding. These limits will be included in the instructions sent with the NMSN.

Otherwise, follow the steps below to comply with the NMSN.

  • Part B- Medical Support Notice To Plan Administrator. This document should be forwarded to your health care plan administrator for handling.
  • "Plan Administrator Response." This is completed by your Plan Administrator according and returned to the Issuing Agency.

What To Do When You Receive a NMSN.

  • Step 1: Once you receive the NMSN, determine whether any of the four categories on the Employer Response apply. You may only be able to determine whether one of the first three apply at this stage.
  • Step 2: If so, complete the Employer Response form and return it to the Issuing Agency within 20 business days. If none of the four categories apply to you or this employee, forward Part B to your plan administrator.
  • Step 3: The plan administrator will notify you when enrollment has been completed. You must then notify your payroll to make the deductions for employee payment required under the health plan. 
  • Step 4: If the amount of child support and the premium payment is more than the allowed wage deduction amount, you must determine the priority for payment. For help with the priority for payment please contact the Issuing Agency.
  • Step 5: If enrollment cannot be completed until after a waiting period, you must notify the Plan Administrator when the employee is eligible.

All State Medical Support Contact Matrix