The CSEA must enforce support orders with health insurance coverage or collection of court ordered medical support.  A medical support order is binding on the person paying child support, their employers and any insurer that provides health insurance coverage for either parent or their children.

The National Medical Support Notice (NMSN) is a federally required form used to enforce medical support orders for minor children.  The NMSN has instructions for the employer and the health plan administrator. It’s sent out within two days after the parent starts working. It is to be used throughout the United States to enroll children in employment related health insurance coverage.  The NMSN is only required for employment-based insurance coverage and is sent to the employer of the person who is ordered to provide medical insurance coverage.

The NMSN is a 14-page document with instructions for the employer and health plan administrator on how to enroll children in court order medical insurance..

Definitions:

Health Plan Administrator is the person at the health insurance agency responsible for processing the National Medical Support Notice (NMSN)

Medical Insurance (MI) Obligee is the party that is not responsible for providing health insurance.

Medical Insurance (MI) Obligor is the person that is required to provide health insurance under a medical insurance order.

Medical Insurance (MI) Order is the requirement within a child support order for one or both of the parties provide health insurance.

How is the MNSN used?

The Child Support Enforcement Agency (CSEA) in the county with your child support/medical insurance order sends the NMSN to the health plan administrator in 20 business days from the order being established unless the employer does not provide insurance.  The health plan administrator will enroll the child/ren 20 days after receiving the NMSN, unless there is a waiting period of there is more than one health insurance plan option. In those cases, enrollment takes place when the waiting period ends, or the plan option is selected by the person providing the medical insurance.  There is a waiting period or there is more than one health insurance plan option.  In those cases, enrollment takes place when the waiting period ends, or the plan option is selected by the person providing the medical insurance.

MI Obligor Questions and Answers

I received a notice of medical support activity.  What does this mean?

The Notice of Medical Support Enforcement Activity was sent to tell you that the CSEA has sent a copy of the NMSN to your employer.  This NMSN is required by federal law and the Ohio Revised Code.  It was sent to your employer because the CSEA believes that you are under a court or administrative order to provide medical insurance for your child/ren and the CSEA just discovered that you are employed or changed employment.

What will my employer do with the NMSN?

The NMSN requires your employer to enroll your children in any medical insurance it has available for them and withhold the premiums from your paychecks.

What if I don’t agree with the information in the Notice of Medical Support Enforcement Activity?

You have a right to request an administrative mistake of fact hearing if you believe you are not the person named by the Notice, or if you have not been ordered to provide medical insurance for your children.  Complete and send in the last page of the Notice to the CSEA within 14 days of the date of the Notice.

I can’t afford to pay for medical insurance for my children. What can I do?

When your employer gets the NMSN, they will have to determine whether the amount of the amount of the medical insurance premium will be more than the percentage allowed under the definition of reasonable under current law. You will only be required to provide health insurance if the premium cost is reasonable.

“Reasonable cost” means that the cost of health insurance coverage to the person required to provide health insurance coverage for the children who are the subject of the child support order does not exceed an amount equal to five per cent of the annual income of that person.

You may also have the right to request a review and adjustment of your child support order from the CSEA if you believe you financial situation has changed.  You should ask you CSEA about specific requirements for a review.