The National Medical Support Notice helps make sure children have health insurance. It's used across the U.S. to help parents enroll their children in health insurance through their jobs.
If a parent has a child support order that includes providing health insurance, DCS will send you, the employer, an NMSN notice. The notice explains how much money should be taken from the parent's paycheck for health insurance, what to do if there is not enough money for both child support and health insurance, and how long the obligation lasts.
Understanding the National Medical Support Notice
The NMSN contains two separate sections: Part A and Part B.
Part A is the Notice to Withhold for Health Care Coverage. It includes information about the case and the employee. In this section, you'll find:
- A cover letter.
- The notice to withhold for health care coverage.
- An employer response form.
- Instructions for the employer.
Part B is the Medical Support Notice to Plan Administrator. This should be given to the person who handles your employer’s health insurance plan. In this section, you'll find:
- A cover letter.
- A Washington state addendum to Box 2 of the plan administrator response.
- The notice to be given to your plan administrator.
- A plan administrator response form.
- Instructions for your plan administrator.
Choose the option below that describes how health insurance is provided to your employees.
My employee's union provides medical insurance.
If the employee's union provides medical insurance, send the entire Part B section of the National Medical Support Notice to the union's third-party administrator within 20 business days after the date of the notice.
My company's benefits are handled by a third party.
If your company's benefits are handled by a third party, send the entire Part B section of the National Medical Support Notice to the benefits office within 20 business days of the date of the notice.
We handle our own medical insurance enrollments.
If you handle your own medical insurance enrollments, do the following:
- Follow the Part A, "Instructions to Employer,” and Part B, "Instructions to Plan Administrator.”
- Enroll the children in your insurance plan or in an insurance plan that is available within the premium limit stated in the notice.
- Medical insurance enrollment has priority over dental insurance enrollment.
- If the insurer requires employee enrollment to enroll the children, enroll both the employee and children. (See the Unlawful Refusal to Enroll paragraph in the “Instruction to Plan Administrator.”)
- Withhold the premium from the employee's wages, and forward the premium to the insurance company.
- Complete the "Plan Administrator Response" form and the "Washington State Addendum to Box 2 of Plan Administrator Response.”
- Send both forms to DCS within 40 business days of the date of the notice.
My company does not offer medical insurance.
If your company doesn't provide health insurance, mark Box 2 or 3 on the "Employer Response" form and return the form to DCS within 20 business days of the date of the notice.