Q&A: Learn how to deal with a National Medical Support Notice

Q: What is a National Medical Support Notice and how do we respond?
A: A National Medical Support Notice enforces a child support order for a noncustodial parent who is required to provide health care coverage through an employer group health plan. These notices are issued by the Texas Attorney General to districts to enforce a medical support obligation.
The district must confirm the employee’s eligibility for health insurance coverage and complete the notice. If the employee is eligible, the notice must be forwarded to the plan administrator within 20 business days of its receipt. If the employee is not eligible for insurance coverage, the district has 20 business days to complete and return the notice to the Office of the Attorney General (OAG).
Employees subject to medical support orders are required to enroll their child or children in the district’s health plan even if they claim that the child is covered under CHIP, Medicaid, or another health plan. If they fail to do so, the plan administrator is required to comply with the order and enroll the child or children in the plan. Should an employee refuse to sign the benefit election form, the district must send the forms to the OAG for authorization to enroll the child.
Once enrolled, the district is required to withhold the associated employee health insurance contributions up to any statutory limits set by state or federal law.
The district is also required to notify the OAG if the employee loses eligibility for the district’s health insurance (e.g., loses coverage for failure to pay premiums during an unpaid absence).
Detailed guidance on complying with medical support requirements is available in the form of frequently asked questions on the Texas Attorney General’s Website and from the U.S. Department of Labor.