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Giving Hope and Support to America's Children |
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Federal Parent Locator Service |
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What's New With Medical Support?
A Guide for Employers
July 2006
The presentation consists of the following:
Medical Support Goals
Meeting the medical needs of children.
- Obtain medical support for all children.
- Enforce existing orders to provide health care coverage.
- Promote use of a standardized notice to employers for initiating insurance coverage.
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Medical Support Legislation
- 1984
- States required to secure medical support information and obtain health insurance coverage from NCP when available at a reasonable cost.
- 1993
- Removal of impediments made it easier to secure and enforce medical coverage for children.
- 1996-1998
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- Health Care coverage provision required in all IV-D orders.
- Establishment of the Medical Support Working Group:
- To identify barriers to appropriate health care.
- To assist in development of a National Medical Support Notice (NMSN).
- 2005
- Deficit Reduction Act of 2005
- Effective October 1, 2005, unless a state law change is required, all IV-D support orders must include a provision for medical support to be provided by either or both parents.
- Enforcement against the custodial party (CP) is optional.
- Employers may see the National Medical Support Notice used to enforce a support order against a CP.
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National Medical Support Notice
States are now required to use the NMSN to notify employers and health care plan administrators of the order requiring the employee to cover dependents.
- Constitutes a Qualified Medical Child Support Order and meets ERISA requirements.
- Provides name and address of issuing agency contact.
- Contains issuing state law provisions or state policy for:
- Withholding employee health insurance contribution,
- Priority between child support and health insurance when funds are insufficient to cover both, and
- Duration of the obligation.
The NMSN is actually 4 different documents plus instructions to the employer
and the plan administrator:
- Part A - Notice to Withhold for HealthCare Coverage
- Employer Response
- Part B - Medical Support Notice to Plan Administrator
- Plan Administrator Response
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Part A - Notice to Withhold for Health Care Coverage
Part A will be completed by the child support agency to provide identifying information to the employer about the case and the employee.
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Employer Response
- NMSN should be directed to Human Resources or personnel dept.
- Employer Response should be completed and returned to Issuing Agency when:
- Employer does not provide health care coverage,
- Employee is ineligible for health coverage due to work status, or
- Employee has been terminated.
- Part B is forwarded to Plan Administrator
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Part B - Medical Support Notice to Plan Administrator
- Notifies the Plan Administrator of the obligation to provide health care coverage.
- Plan Administrator has 40 business days to complete and return the response to notify the Issuing Agency of action taken.
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Plan Administrator Response
Plan Administrator must:
- Enroll child(ren) in health care plan and notify issuing agency and parents, or send them information if options exist.
- Notify employer so that payroll can make proper deductions.
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Payroll's Responsibilities
- Once notified of enrollment by the Plan Administrator, payroll must begin deductions for premiums from employee's pay.
- If the limitations on withholding and the state's priority for withholding make it impossible to deduct the premiums, No.4 on the Employer Response should be checked and the Response sent to the Issuing Agency.
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Update from OCSE
- All states are currently using the NMSN-many have automated the process.
- OCSE continues to provide assistance to states addressing policy and employer concerns.
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Last modified: August 30, 2006
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