Frequently Asked Questions

Welcome to DSHS Economic Services Administration's Frequently Asked Questions!

  • Respond to Part A, Notice to Withhold for Health Care Coverage by returning the Employer Response or by calling DCS.
  • If you serve as your own plan administrator, respond to Part B, Medical Support Notice to Plan Administrator by completing the Plan Administrator Response and the Washington State Addendum to Box 2 of Part B - Plan 

If you have questions about the National Medical Support Notice, you can get help in the following ways:

  • Within 20 business days after the date of the Notice:
    • Check the appropriate box and send the Employer Response to DCS, or call DCS with the appropriate response.
    • Send Part B, Medical Support Notice to Plan Administrator to the office or labor union who administers the health care plan.
  • If you serve as your own plan administrator, return the Plan Administrator Response to DCS within 40 business days after the date of the Notice.

If you have questions about the National Medical Support Notice, you can get help in the following ways:

After the children are enrolled, the plan administrator will notify you to withhold the premium from the employee's earnings.

Refer to "Cover Letter for the National Medical Support Notice - Part A-", Section #2:

  • Shows how much the employee has to pay for the children on that Notice.
  • Add the amount on each Notice together to get a total. This is the most the employee has to pay to cover only the children listed on the Notices.
  • If one NMSN has a set amount and another has no limit, the total is "no limit".
  • If the cost to enroll the children is more than the total premium limit, mark box 5 on the Employer Response and tell DCS the cost of the children's premium. (Example: Premium cost is $ ________.)

NO. The premium limit shown on the Notice applies only to the additional cost the employee has to pay for the children's coverage.

EXAMPLE: If the cost for the employee only coverage is $33 per month and the cost for the employee plus children is $85 per month then the cost for the children only is $52 per month. ($85 -$33 =$52). If the premium limit on the notice is $52 or more, you would have to enroll both the employee and the children.

NO. The premium limit shown on the Notice applies only to the additional cost the employee has to pay for the children's coverage.

EXAMPLE: If the cost for the employee only coverage is $33 per month and the cost for the employee plus children is $85 per month then the cost for the children only is $52 per month. ($85 -$33 =$52). If the premium limit on the notice is $52 or more, you would have to enroll both the employee and the children.

Send Part B Medical Support Notice to Plan Administrator (including the Cover Letter and Washington State Addendum to Box 2) to the union's third party administrator. Check box 7 on the Employer Response form, enter the date Part B was sent, and send the Employer Response to DCS.

Yes. The employer must promptly notify DCS when the employee is no longer employed.

The employee is required to provide insurance coverage that is accessible to the child. Under the Revised Code of Washington and the Washington Administrative Code, "Accessible coverage" means health insurance coverage which provides primary care services to the children with reasonable effort by the custodian.

Do not enroll the child if the coverage is not accessible to the child. Notify DCS that the child cannot be enrolled and tell DCS why.

DCS does not require that the employee be moved to another plan because DCS has no way of knowing if the employee has a spouse and/or other children already covered on his/her current plan. Some plan administrators will make the employee change plans to one that will cover the child where the child lives when the employee is the only one on the plan. However, this decision is up to the individual plan administrator.

YES. As long as the cost of the children's premium does not exceed the limit in the Notice and the current child support amount plus the cost of the premium for the employee and children does not exceed 50% of the employee's net disposable income.

  • If insurance IS available through a union, send Part B to the union's third party administrator.
  • If insurance IS NOT available through a union, check box 2 on the Employer Response form and send the response to DCS.

If you have questions about the National Medical Support Notice, you can get help in the following ways:

If you offer insurance for which the children are eligible, enroll the children, and complete the Washington State Addendum to Box2 of Plan Administrator Response form and the Plan Administrator response form. Return both forms to DCS within 40 business days after the date of the Notice.

  • When the employee is already enrolled, enroll the children in the same plan as the employee.
  • When the employee is not enrolled and there are multiple plans within the premium limit shown on the Notice that would cover the children, DCS will select the plan. Provide DCS the following information about each plan: description of the coverage, additional cost the employee would have to pay to cover the children and whether there is a limited service area for the plan.

Under Washington State law, an employer who fails or refuses to comply with the Notice can be fined up to $1,000 per occurrence.

Check box 5 on the Employer Response form and send the form to DCS and indicate the cost the employee would have to pay for the dependent coverage.

The employee may contest the withholding under the Notice, based on a mistake of fact, by contacting DCS. The employer must continue to withhold the premiums until notified by DCS to discontinue withholding.

The employer has an obligation to comply with the Notice until they receive a Release terminating the medical withholding. The employee should contact DCS immediately and provide proof of coverage.

The plan administrator or employer may complete the Washington State Addendum to Box 2 of Part B - Plan Administrator Response or provide any preprinted information that provides the insurance information. DCS needs the insurance company name, address, telephone number, and the employee's policy or member number, and group number. For federal audit purposes, DCS must have the employee's insurance information in the DCS case files.

When the employee's principal place of employment is Washington State, the priority of withholding is current support first, the health insurance premium second, and past-due support last. When the employee's principal place of employment is not Washington State, the employer will have to contact the child support agency in that state for priority information.