MEDICAL SUPPORT

CS 492P Manual National Medical Support Notice – Procedures

01/03 Revised 07/06/18 Training Completed 07/20/18 Last Reviewed 07/10/25

 

 

Only manually generate a National Medical Support Notice (NMSN) if the case meets the following criteria:

 

1.                   Alternative address – The case meet the criteria for medical support enforcement and the employer has an alternative address for the NMSN.  For example, if the employer uses a payroll service company to do their payroll, but a NMSN should go to the employer’s address.

 

2.                   Bankruptcy – The case meets the criteria for medical support enforcement and it has been coded for a Chapter 11 bankruptcy. 

 

3.                   Intergovernmental – The case meets the criteria for medical support enforcement and it has an open outgoing intergovernmental record. 

 

4.                   Native American – The case meets the criteria for medical support enforcement and it has been suspended for no jurisdiction.

 

5.                   Military – For more information on the military, refer to CS 496P Insurance from a Military Parent.

 

6.                   Missing Insurance Type.

 

7.                   Children-in-Care (CIC) Medical Support Only Case.

 

 

Procedures – Manual National Medical Support Notice (NMSN)

 

Before you initiate a National Medical Support Notice (NMSN) on a noncustodial parent (NCP) who also has a child support obligation, determine if the NCP is or will be paying the support by income withholding.  If you will be manually generating a Notice to Withhold Income for Child Support, you may also generate an NMSN at the same time.  It is not necessary to mail the notices in the same envelope.  If the NCP is already paying by income withholding, and those amounts are not changing, only initiate an NMSN.

 

1.                   Determine whose obligation you are enforcing:  Determine which parent is responsible, the NCP or the custodial parent (CP), for providing insurance on the child(ren) by reviewing the order.

a.                   Either parent ordered to maintain insurance as part of an “either/or” order:  If either parent is ordered to maintain health insurance for the child(ren), if it is available or becomes available to either parent through employment related or other group health insurance, said parent shall be responsible for maintaining insurance for the dependent child(ren).  Although both parents may have insurance available to them, only enforce one parent’s insurance obligation at a time.  In this type of case, CSS has determined that the NCP has the primary responsibility for maintaining the insurance coverage; therefore, if it is available to him/her through his/her employer, enforce the NCP’s insurance.

If both parents obtain insurance coverage and request credit, give each parent an insurance credit. Compute the net credit and adjust the current support due accordingly. 

b.                   Both parents ordered to maintain insurance in a “double coverage” order:  If both parents are judicially ordered (e.g., in a divorce decree) or administratively ordered (e.g., orders taken prior to September 9, 1999) to maintain health insurance for the child(ren), enforce the obligation of both parents.

If both parents obtain insurance coverage either voluntarily or through CSS enforcement and request credit, give each parent the insurance credit.  Compute the net credit and adjust the current support due accordingly. 

 

2.                   Determine the custodial parent’s safeguard/non-disclosure status:  If the obligee’s information is safeguarded or if the CP has a non-disclosure order, do not include the CP and child(ren)’s address in the NMSN.  Instead, complete the “Substituted Official/Agency Name and Address” field using the appropriate local CSS address. 

 

NOTE:  If the CP’s case information has NOT been safeguarded, leave his/her information on the NCP’s copy.

 

3.            Generate and mail the NMSN to the employer by first class mail. Coordinate with any other team(s) that may need to send a NMSN and include their case(s) in the NMSN, if appropriate; e.g., a Child in Care (CIC) case. 

 

4.            Mail the following forms to the appropriate parent by first class mail:

a.                   a copy of the NMSN (Page 1 ONLY);

b.                   the Written Request for Review National Medical Support Notice; and,

c.                   the National Medical Support Notice Cover Letter.

 

5.            Document the actions taken on the case and the reason for generating a manual NMSN.

 

 

New Employer

 

Once a NMSN has been issued for a NCP/CP, it follows their employment in the same manner as a Notice to Withhold.