National Medical Support Notice

ICR 201606-0970-008

OMB: 0970-0222

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2016-08-16
Justification for No Material/Nonsubstantive Change
2013-08-29
IC Document Collections
IC ID
Document
Title
Status
10060 Modified
ICR Details
0970-0222 201606-0970-008
Historical Active 201308-0970-003
HHS/ACF ocse
National Medical Support Notice
Extension without change of a currently approved collection   No
Regular
Approved with change 08/17/2016
Retrieve Notice of Action (NOA) 06/28/2016
  Inventory as of this Action Requested Previously Approved
08/31/2019 06/30/2019 08/31/2016
4,130,946 0 5,279,850
702,261 0 897,575
0 0 0

Section 401 of the Child Support Performance and Incentives Act of 1998 (CSPIA) Pub.L. 105-200 requires State Child Support Enforcement agencies under title IV-D of the Social Security Act (the Act) to enforce the health care coverage provision in a child support order, and to use the National Medical Support Notice (NMSN) as a means of enforcement. The law requires the NMSN to be promulgated by regulations issued jointly by the Departments of Health and Human Service (HHS) and Labor (DOL). The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) requires all child support orders under title IV-D of the Act to have a provision for medical support coverage. CSPIA requires enforcement of this provision and to use the NMSN as a means of enforcement. State and local Child Support Enforcement agencies send the NMSN to known employers where employees/obligors are employed for the purpose of enrollment of the child into the employee/obligor's health plan. The employer retains the severable wage-withholding portion of the form and withholds from the employee/obligor's wages any premium payments that may be required by the plan. The employer sends the remaining portion of the NMSN to the health plan administrator for enrollment of the child.

PL: Pub.L. 105 - 200 401(c) Name of Law: Child Support Performance and Incentive Act
  
None

Not associated with rulemaking

  81 FR 3147 01/20/2016
81 FR 41543 06/27/2016
Yes

1
IC Title Form No. Form Name
National Medical Support Notice-Part A Part A National Medical Support Notice

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,130,946 5,279,850 0 0 -1,148,904 0
Annual Time Burden (Hours) 702,261 897,575 0 0 -195,314 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The burden was reduced due to an adjustment in fewer expected responses.

$0
No
No
No
No
No
Uncollected
Robert Sargis 2026907275

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/28/2016


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