Income Withholding for Dependent Health Insurance (Medical Support)
Employers promote the well-being of children by withholding health insurance premiums from noncustodial parents' earnings.
When a noncustodial parent is ordered to provide health insurance for dependent children, the employer will receive a National Medical Support Notice (NMSN) (PDF). The NMSN consists of two parts. Part A must be completed by the employer. Part B must be completed by the Plan Administrator, which may be the employer or another organization, such as a labor union.
An employer must respond to the NMSN not later than 20 business days after the date of the Notice.
Not your employee?
If the employee or independent contractor named on a National Medical Support Notice does not work for you, complete Item 1 or Item 4 and the Completed By section of Part A (EMPLOYER RESPONSE) and return Part A to the Issuing Agency as soon as possible.
If you need a copy of the NMSN, call the Child Support Helpline at 1-888-208-4485 (TTY: 1-866-875-9975), Monday–Friday, 8:00 AM–7:00 PM. A copy will be mailed to you in 5–7 business days.
When you receive a National Medical Support Notice (NMSN)
Even if health care coverage is not available to the employee or independent contractor through your organization, complete the appropriate steps to respond to the NMSN:
- Verify the identifying information in Part A, Page 1
- Not later than 20 business days after the date of the Notice:
Return Part A—if coverage is not available or not yet available
—or—
Send Part B to the Plan Administrator - Withhold the health insurance premium
- Notify the Issuing Agency of employee termination
Verify the identifying information in Part A, Page 1
When you receive the NMSN, you should immediately read the NOTICE TO WITHHOLD FOR HEALTH CARE COVERAGE (Part A, Page 1). Verify all the information, especially the Issuing Agency, the Notice date, the court information, your organization's name and address, and the employee or independent contractor's information.
If you have any questions about any of this information, contact the Issuing Agency immediately.
If the person named is not your employee, continue to the EMPLOYER RESPONSE (Part A, page 3), complete Item 1 or Item 4 and the "Completed By" section, and return Part A to the Issuing Agency.
Return Part A—if coverage is not available or not yet available
Review the numbered items in Part A, EMPLOYER RESPONSE. Items 1 through 6 describe circumstances when enrollment in health care coverage is not possible for the employee. Items 7 through 8 describe circumstances where dependent enrollment is not yet available.
If any of the first eight items applies, mark the appropriate box, complete the "Completed By" section at the bottom, and return Part A to the Issuing Agency no later than 20 days from the date of receipt of the Notice. Keep a copy for your records, but you do not need to do anything else.
| Part A Employer Response ITEMS | If YES… | Otherwise… |
|---|---|---|
| 1. Employee has never been employed by this employer | Check Box 1, complete "Completed By" section, and return Part A to the Issuing Agency. | Forward Part B to Plan Administrator as
soon as
possible, check Box 9, and enter the date Part B
was forwarded. You must send Part B not later than 20 business days after the date of the Notice. |
| 2. Employer does not provide dependent or family health care coverage | Check Box 2, complete "Completed By" section, and return Part A to the Issuing Agency. | |
| 3. Employee is permanently ineligible for coverage | Check Box 3, complete "Completed By"
section,
and return Part A to the Issuing Agency. Do NOT check this item if the employee will become eligible. |
|
| 4. Employee is no longer employed by this employer | Check Box 4 and provide information about separation. If you have information about the new employer, check Box 6 and provide the new job information for the employee. Complete "Completed By" section and return Part A to the Issuing Agency. | |
| 5. Withholding limitations and/or prioritization prevent withholding of the premium for health care coverage | Check Box 5, complete "Completed By" section, and return Part A to the Issuing Agency. | |
| 6. Other | Check Box 6 if you have information about dependent health care coverage being provided by a third party or some other reason for no coverage, complete "Completed By" section, and return Part A to the Issuing Agency. | |
| 7. Waiting period applies | Check Box 7, provide information about the waiting period, complete "Completed By" section, and return Part A to the Issuing Agency. | |
| 8. Employee is on an unpaid leave of absence | Check Box 8, provide the expected date of the employee's return, complete "Completed By" section, and return Part A to the Issuing Agency. |
Send Part B to the Plan Administrator
If your organization offers health insurance coverage and the employee or independent contractor is or will become eligible, send Part B of the NMSN (7 pages) to the Plan Administrator as soon as possible. You must send it not later than 20 business days after the date of the Notice.
The Plan Administrator must complete Part B and return it to the Issuing Agency within 40 business days after the date of the Notice. If you are also the Plan Administrator for your company, then you must complete Part B and return it to the Issuing Agency within 40 business days.
Otherwise, wait for notification from the Plan Administrator. If you do not receive a timely response, contact the Plan Administrator to be sure Part B has been completed and returned to the Issuing Agency.
A response to Part B of the NMSN is required within 40 business days after the date of the Notice.
Withhold the health insurance premium
When you are notified by the Plan Administrator that the children have been enrolled in health care coverage, you should begin withholding any employee contributions to the group health plan, as required and allowed by law, including the limitations on withholding required by the Consumer Credit Protection Act (CCPA) and State regulation (18 NYCRR 347.9[a][2][iv][h][12]).
Waiting period
The Plan Administrator may notify you that the employee or independent contractor is subject to a waiting period that expires more than 90 days from the date the Plan Administrator received the NMSN or a waiting period that depends on another requirement, such as number of hours worked. If you receive notification of a waiting period, complete and return Part A (Item 7 of the EMPLOYER RESPONSE) to notify the Issuing Agency of the enrollment timeframe. Notify the Plan Administrator again when the employee is eligible to enroll.
Calculate withholding limitations
Use the Withholding Limitations Worksheet (PDF) or the online calculator to help you determine whether you can withhold the health insurance premium. The Withholding Limitations Worksheet page and the Income Withholding Cases with Prorated Amounts page explain in detail how to determine when you can withhold the health insurance premium.
The full amount of the health insurance premium must be withheld; the premium cannot be prorated or paid in part. Withholding the health insurance premium depends on the answers to these questions:
- Is the total of all obligations—current, past-due, and other amounts plus
the health insurance premium—less than the Maximum Withholding for
the employee or independent contractor?
If yes, withhold the health insurance premium and the full amount of all obligations. - Is the total of all the current support obligations—plus the health
insurance premium—less than the Maximum Withholding?
If yes, withhold the premium, the current obligation amounts, and any remaining amount up to the Maximum Withholding (see an example).
Unless you can answer "yes" to one of these questions, you cannot withhold the health insurance premium.
Be sure to remit the amount of the premium to the appropriate health care plan.
Notify the Issuing Agency if enrollment cannot be completed
If the employee or independent contractor's earnings do not allow the full health insurance premium to be withheld, complete Part A (Item 5 of the EMPLOYER RESPONSE) and the "Completed By" section at the bottom of the page and return Part A to the Issuing Agency as soon as possible. Keep a copy for your records, but you do not need to do anything else. You will receive a termination notice from the Issuing Agency.
Notify the Issuing Agency of employee termination
When the employee or independent contractor leaves your employ for any reason, complete Part A (Item 4 of the EMPLOYER RESPONSE) and the "Completed By" section at the bottom of the page. Return Part A to the Issuing Agency as soon as possible. If you require an official cancellation of your obligation to withhold employee contributions to the group health plan, a termination NMSN can be sent to you upon your request.