Health Insurance


Employer Responsibilities | Processing the NMSN | Dental and Vision Insurance | Medical Insurance Cards | Employee Refuses to Enroll | Out of Coverage Area Enrollment

National Medical Support Notice

The National Medical Support Notice is a court order that requires the noncustodial parent’s employer (or other person providing health insurance) to enroll the child in the parent’s health insurance plan.

The order also authorizes the employer to deduct the cost of the health care premiums from the noncustodial parent's earnings. The employer is instructed to notify the Department of Child Support Services of any lapse or change in the health insurance coverage.

Employer Responsibilities

It is the responsibility of the employer to enforce the National Medical Support Notice, even if the health benefits are paid through a union trust. If medical coverage is available at a reasonable cost and the employer fails to enroll and send in coverage details, the court may find the employer in contempt. The resulting penalties can include a fine. The employer may have to appear in court and seek legal representation to address the non-compliance of a court order.

Processing the National Medical Support Notice

Employees are eligible for health insurance benefits if the price of the coverage and the child support withholding do not exceed 50 percent of the employee’s net income after taxes. Eligible employees do not have the option to refuse health insurance coverage.

Employers must follow strict timelines to comply with the National Medical Support Notice.

Within 20 business days of receipt of the Notice, employers must forward the instruction to enroll to the designated plan administrator. Once enrollment is verified with the effective date, the employer must complete the Medical Insurance Form (DHS 6110) and return it to the child support agency. Paycheck deductions should begin within the first 30-day period of receiving the National Medical Support Notice. Employers may not deduct wages for a date prior to receipt of the Notice.

Within 40 business days, the employer must provide the Department of Child Support Services with:

  • A description of the coverage available
  • The effective date of the coverage
  • A summary plan description
  • Any forms or documents
  • Any information necessary to submit claims for benefits

Dental and Vision Insurance

The dependent should be enrolled in dental and vision insurance if it is available at no additional cost or at a reasonable cost. If the employee has already enrolled himself/herself in dental and vision coverage, then the dependent(s) should be enrolled as well. If cost is an issue, contact the department for further review.

Medical Insurance Cards

Employers are to assist the custodial family in receiving all materials necessary to access the health care coverage. This includes all medical insurance cards. If the medical insurance cards come directly to the employee the employee, should give the cards to the employer for forwarding to the Department of Child Support Services (DCSS). DCSS will then forward the cards to the custodial family.

If the employer is not able to convince the employee to surrender the cards, then it becomes the employer’s responsibility to have the provider either send the cards directly to the department or to the employer.

When contacting the health care provider to request the medical insurance cards, include a copy of the court order and ask to speak to a supervisor or legal council. If these attempts are unsuccessful, contact the Department of Child Support Services for assistance.

Employee Refuses to Enroll

Health insurance enrollment is court ordered. If the employee refuses to cooperate then the employer may enroll the dependent(s) without the employee’s assistance. The employee does not have to be involved. On the signature line of the enrollment forms write, “Per court order - copy attached.”

If the employee is not currently enrolled, and their enrollment is required to enroll the dependent(s), then you will be required to enroll the employee. Since the court has set guidelines regarding cost, you may contact the Department of Child Support Services to discuss the cost of enrolling both the employee and the dependent(s) before proceeding.

Out of State / Out of Coverage Area Enrollment

If the dependent lives out of state or outside of the insurance coverage area contact the Department of Child Support Services. Depending on the insurance provider, there may be a “guest membership enrollment” available and insurance coverage may extend to another state.

Frequently Asked Questions