Information Collection Request

National Medical Support Notice - Part A

ICR 202509-0970-004 · OMB 0970-0222 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1 National Medical Support Notice Part A Form New Available
Form 1 National Medical Support Notice Part A Form New Available
Form 1 National Medical Support Notice Part A Form New Repair queued
Form 1 National Medical Support Notice Part A Form New Available
Form 1 National Medical Support Notice Part A Form Modified Available
Form 1 National Medical Support Notice Part A Form Modified Repair queued
Form NMSN Matrix State Medical Support Contacts and Program Requirement Matrix Form Modified Available
Form NMSN Matrix State Medical Support Contacts and Program Requirement Matrix (State Respondents) - Implementation Year Form Modified Repair queued
Form 1 National Medical Support Notice Part A Form Modified Available
Form 1 National Medical Support Notice Part A Form Modified Available
NMSN_EmilyGregg_10.9.25.msg Public Comments Uploaded 2025-10-15 Available
Proposed Information Collection Activity National Medical Support Notice Part A OMB #0970-0222 FR DOC. 2025-11585 Filed 62325_email 7.25.25.msg Public Comments Uploaded 2025-07-25 Available
NMSNAug25Final_Alice Jacobsohn_8.14.25.pdf Public Comments Uploaded 2025-11-18 Available
NMSN_EmilyGregg_10.9.25.msg Public Comments Uploaded 2025-10-09 Repair queued
nmsn ideas_email Paula Rowland_6.24.25.msg Public Comments Uploaded 2025-06-24 Available
National Medical Support Notice Revisions – Part A open for Public Comment_Hine_6.27.25.msg Public Comments Uploaded 2025-06-27 Available
National Medical Support Notice Revisions – Part A open for Public Comment_Hine_6.27.25.msg Public Comments Uploaded 2025-11-18 Available
National Medical Support Notice Feedback_Elizabeth Johnson_email 6.24.25.msg Public Comments Uploaded 2025-06-24 Available
Comments - Revised NMSN - Part A - OMB 0970-0222_VDSS_email 8.22.25.docx Public Comments Uploaded 2025-08-22 Available
NMSN Response to Comments - 30 Day FRN.docx Supplementary Document Uploaded 2025-11-18 Repair queued
Tennessee Comments on Federal Register- National Medical Support Notice Part A_Oct 2025.pdf Public Comments Uploaded 2025-10-16 Repair queued
PC_202509-0970-004_101625_094650_1.pdf Public Comments Uploaded 2025-10-16 Repair queued
PC_202509-0970-004_101625_070916_1.pdf Public Comments Uploaded 2025-10-16 Available
PC_202509-0970-004_101525_105017_1.pdf Public Comments Uploaded 2025-10-15 Available
2025-08-29 NMSN Part A Supporting Statement FINAL_9.12.25.docx Supporting Statement A Uploaded 2025-09-12 Available
2025-08-29 NMSN Part A Supporting Statement FINAL_9.12.25.docx Supporting Statement A Uploaded 2025-09-12 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
277536 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) - 2026 Forward Form NewNational Medical Support Notice Part A
277536 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) - 2026 Forward Instruction New
277535 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) - 2026 Forward Form NewNational Medical Support Notice Part A
277535 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) - 2026 Forward Instruction New
277534 National Medical Support Notice-Part A (Employer Respondents) - 2026 Forward Form NewNational Medical Support Notice Part A
277534 National Medical Support Notice-Part A (Employer Respondents) - 2026 Forward Instruction New
277533 National Medical Support Notice-Part A (State Respondents) - 2026 Forward Form NewNational Medical Support Notice Part A
277533 National Medical Support Notice-Part A (State Respondents) - 2026 Forward Instruction New
264137 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) - Implementation Year Form ModifiedNational Medical Support Notice Part A
264137 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) - Implementation Year Instruction Modified
264134 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) - Implementation Year Form ModifiedNational Medical Support Notice Part A
264134 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) - Implementation Year Instruction Modified
255976 State Medical Support Contacts and Program Requirement Matrix (State Respondents) - Implementation Year Form ModifiedState Medical Support Contacts and Program Requirement Matrix
255976 State Medical Support Contacts and Program Requirement Matrix (State Respondents) - Implementation Year Form Modified
236881 National Medical Support Notice-Part A (Employer Respondents) - Implementation Year Form ModifiedNational Medical Support Notice Part A
236881 National Medical Support Notice-Part A (Employer Respondents) - Implementation Year Instruction Modified
10060 National Medical Support Notice-Part A (State Respondents) - Implementation Year Form ModifiedNational Medical Support Notice Part A
10060 National Medical Support Notice-Part A (State Respondents) - Implementation Year Instruction Modified
ICR Details
0970-0222 202509-0970-004
Active 202504-0970-026
HHS/ACF OCSE
National Medical Support Notice - Part A
Revision of a currently approved collection   No
Regular
Approved without change 12/19/2025
Retrieve Notice of Action (NOA) 09/16/2025
  Inventory as of this Action Requested Previously Approved
12/31/2028 36 Months From Approved 12/31/2025
19,181,513 0 9,771,527
3,251,272 0 1,657,190
0 0 0

The Office of Child Support Enforcement (OCSE) developed the National Medical Support Notice (NMSN) - Part A in accordance with the Child Support Performance and Incentives Act of 1998 and the Employee Retirement Income Security Act of 1974. The laws required OCSE to promulgate NMSN regulations, which were issued jointly by the Departments of Health and Human Services and Labor. The information collection activities associated with the NMSN are authorized by (1) 42 U.S.C. § 666, which requires all child support orders to include a provision for medical support, and where appropriate, enforced through the National Medical Support Notice; and (2) 29 U.S.C. § 1169, which provides for medical coverage pursuant to a qualified medical support order. The NMSN Part A is a standard, required form that child support agencies (CSAs) use to ensure employers enroll dependent children in available employer-sponsored medical coverage, if required by a child support order. The Department of Labor develops and maintains the required Part B form (OMB #: 1210-0113) that employers use to inform a plan administrator that a participant is obligated by an order to provide health care coverage for dependent children. This request is for a revision to the currently approved information collection. Please see A.15 of Supporting Statement A for an explanation about the changes.

US Code: 29 USC 1169 Name of Law: Additional standards for group health plans
   US Code: 45 USC 303.32 Name of Law: National Medical Support Notice
   PL: Pub.L. 105 - 200 401(c) Section 609 Name of Law: Child Support Performance and Incentive Act
   US Code: 42 USC 666 Name of Law: Requirement of statutorily prescribed procedures to improve effectiveness of child supp enforcement
  
None

Not associated with rulemaking

  90 FR 26818 06/24/2025
90 FR 44684 09/16/2025
Yes

9
IC Title Form No. Form Name
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) - 2026 Forward 1 National Medical Support Notice Part A
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) - Implementation Year 1 National Medical Support Notice Part A
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) - 2026 Forward 1 National Medical Support Notice Part A
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) - Implementation Year 1 National Medical Support Notice Part A
National Medical Support Notice-Part A (Employer Respondents) - 2026 Forward 1 National Medical Support Notice Part A
National Medical Support Notice-Part A (Employer Respondents) - Implementation Year 1 National Medical Support Notice Part A
National Medical Support Notice-Part A (State Respondents) - 2026 Forward 1 National Medical Support Notice Part A
National Medical Support Notice-Part A (State Respondents) - Implementation Year 1 National Medical Support Notice Part A
State Medical Support Contacts and Program Requirement Matrix (State Respondents) - Implementation Year NMSN Matrix State Medical Support Contacts and Program Requirement Matrix

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 19,181,513 9,771,527 0 9,409,986 0 0
Annual Time Burden (Hours) 3,251,272 1,657,190 0 1,594,082 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
OCSE removed the State Medical Support Contacts and Program Requirement Matrix, which constitutes a program change. This change resulted in only a minimal overall reduction in burden costs because of an increase in employee wages. The overall burden hour was reduced due to a decrease in state responses and a decrease in the number of employer respondents. The time per response remains the same.

$332,060
No
    Yes
    No
No
No
No
No
Molly Buck 202 205-4724 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/16/2025