Medical Support Enforcement

In this Topic

  1. Introduction
  2. Provisions of Coverage
  3. Identifying Cases and Selection Criteria
  4. Employer Procedures for Processing NMSN
    1. Part A—Notice to Withhold for Health-Care Coverage
  5. Probation Child Support Enforcement Operations Manual
  6. NJCSI Handout Materials
  7. Related Information

Introduction

Current federal regulations require that every child support order include a provision of health-care coverage enforced by a state CSChild Support agency. States are required to include provisions for health-care coverage in their Child Support Guidelines. In addition, the Title IV-D agency is required to enroll the children in private health-care coverage when such coverage is available through an NCPNon-custodial parent’s employer at a reasonable cost.

The NMSNNational Medical Support Notice was developed by the federal OCSEOffice of Child Support Enforcement to facilitate the enforcement of medical support. New Jersey began using the NMSN in October 2003. It comprises two parts:

  • Part A, Notice to Withhold for Health-Care Coverage, and
  • Part B, Medical Support Notice to Plan Administrator

The NMSN is intended to provide a standardized means of communication between state CSE agencies, employers, and administrators of group health plans regarding the health-care obligations of NCPs. The notice facilitates the process of enrolling children in the group health plans for which their NCPs are eligible through employment. The NMSN is administered by the NJCSESCNew Jersey Child Support Employer Services Center.

Provisions of Coverage

Health-care provision is part of the child support order and is often provided through the NCP’s employee benefits package or through a private insurance planinsurance plan Rule 5:7-4(a) . Health-care provision can take several forms. The NCP may be ordered in combination or singularly to do the following:

  • Provide health-care coverage if it is available through his or her employer or union at a reasonable cost
  • Pay the CPCustodial parent or party for private health-care coverage premiums or reimburse the CP for all or a portion of the costs of health-care coverage obtained by the CP
  • Pay additional amounts to cover a portion of ongoing medical bills or to reimburse the CP for uninsured medical costs

State law requires that health-care coverage be provided under a medical support order even if the child was born out of marriage, is not claimed as a dependent for tax purposes, or does not reside with the CP or in the insurer’s service area.

Note: If neither the CP nor the NCP has health-care coverage, the child support order may provide a specific dollar amount to be paid for health-care provisions.

Identifying Cases and Selection Criteria

PCSE Unit staff must continually monitor compliance with the health-care provisions of the support order. In accordance with Rule 5:7-5(a) and 5:7-5(e), if a party fails to provide health insurance coverage, the PCSE Unit must notify the party that failure to comply with the court order may result in enforcement procedures.

Cases that meet the following criteria are selected for medical support enforcement:

  • For an existing case, a Notice to Payor of Income Withholding form is initiated because of a new employer.
  • Domestic violence cases are excluded from medical support enforcement until they are scheduled for court.
  • A child who is eligible for coverage is added.

Employer Procedures for Processing NMSN

Part A—Notice to Withhold for Health-Care Coverage

Upon receipt of a NMSN, the employer must determine whether any of the following five categories on the Employer Response form apply to the employer or the employee (i.e., the NCP):

  1. The employee has never been employed by this employer.
  2. The employer does not maintain or contribute to plans providing dependent or family health-care coverage to our employees.
  3. The employee is among a class of employees (for example, part-time or non-union) that are not eligible for family health coverage under any group health plan maintained by the employer or to which the employer contributes.
  4. Health-care coverage is not available because the employee is no longer employed by the employer.
  5. The deduction cannot be made because of state or federal withholding limits and/or prioritization. These limits and deduction priorities are included in the NMSN instructions or in instructions that the employer has received from the state.

The employer may only be able to determine whether one of the first four applies during the initial review of the NMSN. If category 1, 2, 3, or 4 applies, the employer completes the Employer Response form of Part A and returns it directly to the NJCSESC within 20 business days. If not one of the first four applies to the employer or employee, Part B is forwarded to the employer’s health plan administrator.

If the fifth category is checked and eligible children cannot be added because of withholding limits, Part A is returned to the NJCSESC.

Probation Child Support Enforcement Operations Manual

NJCSI Handout Materials

For NJKiDS instructions on National Medical Support Notice, click the link below:

 

Institute for Families, School of Social Work  Rutgers, the State University of New Jersey - Child Support Program Manual 2020 Release