OMB control number
National Medical Support Notice - Part A
OMB 0970-0222 · HHS/ACF.
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. As part of the most recent revision request, ACF requested an implementation period and estimated burden for a one year implementation period. In reviewing the request in ROCIS, ACF has realized that burden was double counted by the way it was entered into the system. This request fixes that error.
The latest form for National Medical Support Notice - Part A expires 2028-12-31 and can be found here.
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Justification for No Material/Nonsubstantive Change |
Justification for No Material/Nonsubstantive Change |
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Supporting Statement A |
Supporting Statement A |
National Medical Support Notice-Part A (State Respondents) - Implementation Year
Federal Enterprise Architecture: Community and Social Services - Social Services
| Form 1 | National Medical Support Notice Part A | Fillable Fileable | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.