Alaska Department of Revenue CHILD SUPPORT SERVICES DIVISION

Frequently Asked Questions About Medical Enforcement

Table of Contents

1. What about health insurance?
2. What is the National Medical Support Notice (NMSN)?
3. When is the NMSN sent to Employers?
4. Who is responsible for providing health insurance for the child/ren?
5. What if the individual ordered to provide coverage has no coverage available through his/her employer?
6. Can my current spouse or relative provide insurance for the child/ren on my case, and if they do can I get a credit for the cost?
7. Are employers and Health Plan Administrators required to comply?
8. What do I have to do if I currently have Insurance in place for the child/ren.
9. Am I entitled to a credit against my child support obligation for providing Health Insurance to the child/ren?
10. Do I have the right to contest medical enforcement?
11. How often does CSSD verify the availability of Health Insurance for the child/ren?
12. Can I get reimbursed for medical cost (for the child/ren) not covered by insurance? 

1. What about health insurance?

Many child support orders require individuals to provide health insurance for their child/ren and requires the employer to enroll the employee’s children in the company’s health insurance program, with the employee to pay his or her share of the costs.  When health insurance is required in the child support order, child support agencies will send out a National Medical Support Notice also known as an NMSN.

2. What is the National Medical Support Notice (NMSN)?

The National Medical Support Notice (NMSN) is a two-part notice sent to the individual’s employer from the child support agency.  This notice is used nationally to ensure that children receive health care coverage when it’s available and required as a part of a child support order, and to simplify the work required of employers and Health Plan Administrators by providing uniform documents for health care coverage.

3. When is the NMSN sent to employers?

The NMSN is sent when a child support order requires the non-custodial parent (or custodial parent) to provide health care coverage.

4. Who is responsible for providing health insurance for the child/ren?

Normally the non-custodial parent is ordered to provide this coverage.  However, many child support orders now require either or both parents to provide health insurance.

5. What if the individual ordered to provide coverage has no coverage available through his/her employer?

Although the child support order may order an individual to provide health insurance , many employers do not have medical insurance and CSSD need to know that. 

However; most child support orders have a provision that indicate if health insurance becomes available to a parent (custodial or noncustodial), that parent must purchase the insurance , and report this change immediately to CSSD with supporting documentation. What this means is that CSSD will enforce medical against the parent who has medical insurance available to them either through their employer or third party.

6. Can my current spouse or relative provide insurance for the child/ren on my case, and if they do can I get a credit for the cost?

Yes, however, you must provide CSSD with the following documentation:

• Confirmation the children are covered and the effective date of coverage
• Copy of the Insurance Card for the eligible child/ren.
• Insurance providers name, address and phone number
• Policy number and any required identification numbers
• Names of all persons covered
• Confirmation from the employer or insurer of the total cost of coverage for policy holder, spouse, children and other dependents to include the employee only rates, as well as the cost to add additional family members to the policy

7.  Are employers and Health Plan Administrators required to comply?

 Yes.  The federal government requires the use of the NMSN in all states and territories.

8.  What do I have to do if I currently have Insurance in place for the child/ren?

 You, your employer or the Insurance Company must provide CSSD with the following documentation:

• Confirmation the children are covered and the effective date of coverage
• Copy of the Insurance Card for the eligible child/ren.
• Insurance providers name, address and phone number
• Policy number and any required identification numbers
• Names of all persons covered
• Confirmation from the employer or insurer of the total cost of coverage for policy holder, spouse, children and other dependents to include the employee only rates, as well as the cost to add additional family members to the policy

9.  Am I entitled to a credit against my child support obligation for providing Health Insurance to the child/ren?

If you are providing health care coverage for your children through your employer, your spouse’s employer or private insurance and this coverage is made available to the child, we may be able to credit up to 50% of that cost to the monthly child support you owe IF your support order allows for credit.  If the support order authorizes a different percentage or credit amount, we will use that amount. Before CSSD can determine the credit, CSSD must verify that coverage is in place and the cost for the child/ren’s coverage.  If you are requesting credit, you must send CSSD a confirmation notice (or letter) from the insurance provider or employer. 

• Confirmation the children are covered and the effective date of coverage
• Copy of the Insurance card for the eligible child/ren.
• Insurance providers name, address and phone number
• Policy number and any required identification numbers
• Names of all persons covered
• Confirmation from the employer or insurer of the total cost of coverage for policy holder, spouse, children and other dependents to include the employee only rates, as well as the cost to add additional family members to the policy

10.  Do I have the right to contest medical enforcement?

Yes. When CSSD issues a NMSN to your employer you will receive a notice informing you of this action.  This notice allows you the opportunity to contest this action.  Read the notice carefully and make sure you provide CSSD with all the required documentation within the specified time period.

11. How often does CSSD verify the availability of Health Insurance for the child/ren?

If CSSD records indicate health insurance is being provided, CSSD requires this information be verified annually (CSSD will send out notices to verify this information).  If CSSD does not have health insurance information, CSSD will send notices every six months until health insurance is provided for the child/ren.

12.  How can I get reimbursed for medical cost (for the child/ren) not covered by insurance?

This cost can be collected by CSSD only if you obtain a judgment from the court