Form 1 e-NMSN: Employer Profile

Department of Health and Human Services

OMB Control No: 0970-0370
Expiration Date: xx-xx-xxxx

Administration for Children and Families
Office of Child Support Enforcement
Agreement to Exchange Electronic
National Medical Support Notices
By completing and providing the information included in the Electronic National Medical Support Notice (e-NMSN) Employer Profile
Form, the employer or third-party provider agrees that:
The employer, company, or government agency shall have appropriate procedures in place to promptly report confirmed
and suspected information security or privacy incidents, including, but not limited to, unauthorized use or disclosure of
Personally Identifiable Information (PII) involving confidential child support information submitted through OCSE to your
organization. As soon as reasonably practicable after discovery, but in no case later than one hour after discovery of the
incident, the employer, company, or government agency shall report confirmed or suspected incidents to OCSE as specified
in this paragraph. The requirement for the employer, company, or government agency to report confirmed or suspected
incidents involving PII to OCSE is based on federal guidance/requirements from the Office of Management and Budget
(OMB), Health and Human Services (HHS), the Federal Information Security Modernization Act of 2014 (FISMA), and the
United States Computer Emergency Readiness Team (US-CERT).
Incidents must be reported via email to OCSE using the security mailbox address:
[email protected]
The organization will electronically receive and respond to NMSNs issued by states, tribes or territories in the same
manner as mailed notices, within the required timeframes. Response timeframes and other instructions are
available at: https://www.acf.hhs.gov/css/form/national-medical-support-notice-forms-instructions.
The organization will not impersonate any individual, entity, or association; use false headers; or otherwise conceal
or provide misleading information about their identity while receiving NMSNs electronically.
The organization’s representative completing this form is authorized to act on behalf of the employer and
agrees to provide true, correct, current, and complete information about the entity identified in the profile
form.
The organization will consider the electronic version of the NMSN admissible as evidence in the
same way as paper documents.
The organization will provide written notice to the federal Office of Child Support Enforcement at least 30 days before it
intends to stop accepting e-NMSNs.
A third-party provider certifies that it has authorization to participate in e-NMSN on behalf of their clients and will provide
company names, FEINs, and related information to OCSE for the purpose of processing e-NMSNs.

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e-NMSN Employer/Third-Party Provider Profile
Instructions
To complete this form and to respond to NMSNs using PDF forms, you must use Adobe Acrobat Reader Version 10
or later. To download this free software, go to https://www.adobe.com/acrobat/pdf-reader.html.
You must complete the required fields followed by a red asterisk *. If there are errors, a popup box will appear
with information about correcting the error.
Employers:
•

Register as an employer with this form.

•

If applicable, use the e-NMSN FEINs Spreadsheet to identify each subsidiary for which you will receive eNMSNs at the server location entered on this form.

•

Provide Part-A responses on the pick-up server.

•

Provide Part-B responses, when applicable, on the pick-up server.

•
•

If you are using an external plan administrator, forward Part-B to the external plan administrator.
If the NMSN is for an employee whose health insurance is through a union or labor organization, forward
Part- B to the union or labor organization. If you are receiving e-NMSN orders and using a third-party
responder to send responses back to states, it is your responsibility to forward the orders and encourage
the third-party responder to register with the e-NMSN system.

Third-Party Providers (Processing e-NSMNs on Behalf of Clients):
•

If you will receive and respond to orders, register as a third-party provider using this form.

•

If you will only respond to orders do not continue to use this version of the Profile form. Instead, use the Plan
Administrator Profile form and register as “Third Party: Responder Only”. Use the e-NMSN FEINs
Spreadsheet to identify each employer and, if applicable, their subsidiaries for whom you will process eNMSNs.

•

Provide Part-A responses on the pick-up server.

•

Provide Part-B responses, when applicable, on the pick-up server.

•

If the NMSN is for an employee whose health insurance is through a union or labor
organization, forward Part- B to the union or labor organization. Professional employer
organizations that want to receive e-NMSNs on behalf of employers must complete the
profile form as a third-party provider and use the e-NMSN FEIN spreadsheet to list the
FEINs for the employer(s) and any subsidiaries.

Note: Third-party providers, professional employer organizations, plan administrators, or unions that want to
receive e-NMSNs for their own employees must register as an employer.

General Information
Date: *

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(The date you are completing the form using MM/DD/YYYY format.)

FEIN: *

(Primary Federal Employer Identification Number – enter as nine numeric characters with
no hyphen after the second number. This is the FEIN used for the files being transferred.)

Organization Type:

If you select Employer, provide the FEIN spreadsheet with information for
your primary organization and any subsidiaries.
If you select Third Party, provide the FEIN spreadsheet with client information
including employers and subsidiaries.

Organization Name*:

Organization Known as Name (Doing Business As):

Address Information
Enter the employer or third-party provider’s address where child support agencies should mail paper NMSNs. Address
Line 1: *

Address Line 2:
City: *

ZIP Code: *

State: *

ZIP Code Extension:
(Enter a five-digit ZIP code and the optional four-digit extension.)

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Contact Information
Enter the organization’s business, technical support, and alternate contact information.
Note: At least one person must be designated to received automated emails.

Business Contact Information
Enter business contact information for working with OCSE to set up e-NMSN and assist with issue resolution.
First Name: *

MI:

Last Name: *

Email: *

Phone Number: *
Include the area code.

Enter numeric characters only.

Phone Ext:

Format: 1231231111)
Fax Number
Enter numeric characters only.
Include the area code.
Format: 1231231111)

Technical Contact Information
Enter network or system administrator who can provide corporate Internet Protocol (IP) addressinformation and batch
system information.
First Name: *

MI:

Last Name: *

Email: *

Phone Number: *

Fax Number:

Enter numeric characters only.
Include the area code.
Format: 1231231111)
Enter numeric characters only.
Include the area code.
Format: 1231231111)

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Phone Ext:

Alternate Business Contact Information
Enter additional business contact information for working with OCSE to set up e-NMSN and assist with issue
resolution. None of the fields are required.
First Name:

MI:

Last Name:

Email:

Phone Number:

Fax Number:

Enter numeric characters only.
Include the area code.
Format: 1231231111)

Phone Ext:

Enter numeric characters only.
Include the area code.
Format: 1231231111)

Alternate Technical Contact Information
Enter additional technical contact information network or system administrator who can provide corporate
Internet Protocol (IP) address information and batch system information. None of the fields are required.
First Name:

MI:

Last Name:

Email:

Phone Number:

Fax Number:

Enter numeric characters only.
Include the area code.
Format: 1231231111)
Enter numeric characters only.
Include the area code.
Format: 1231231111)

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Phone Ext:

File Information
Review the default selections below and make updates as needed, based on the best option for your organization.

General File Information
Enter information about the file exchange.
Encrypt files: *

Are your files stored behind your organization firewall?
Yes

No

Select Yes if you want OCSE to encrypt all files delivered to
your server. OCSE uses GPG for encryption.
If you select Yes, you must provide your company’s PGP or
GPG encryption key in a separate email when sending this
profile.
This field is required only if you selected No for the Encrypt files
option.

If you are an employer or third-party provider, you are responsible for completing Part-A for OCSE to pick-up and
forwarding Part-B to your organization’s plan administrator or a union, if it is acting as a plan administrator.
Are you receiving e-NMSNs and forwarding both Part A and Part B to a third-party responder for processing and
responding?
Yes

No

If you select Yes, we encourage you to have the third-party responder create a profile to use the e-NMSN system. Until
the third-party responder is participating in e-NMSN, it is the employer’s responsibility to forward the NMSN orders to
the third-party responder and receive them back to place on the employer’s pick-up server for OCSE.
If you selected No, who will return Part-B of the e-NMSN response?
Employer or Third-party Provider
Plan Administrator and/or Union
If you selected Plan Administrator and/or Union, complete the e-NMSN FEIN spreadsheet, including the Plan
Administrators tab, and return it with this form.
Note: If you are an employer or third-party provider and are using an external plan administrator to respond to Part-B of
the NMSN, encourage them to participate in e-NMSN.

File Processing Information
How do you want to receive and respond to e-NMSNs?
No Programming and Programming Option information is listed
next.
(System-to-System)

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No Programming File Information
•
•
•
•

•

You will receive the NMSN and Parts A and B in PDF format.
You will receive a daily “Processing Summary” of the files that have been picked up from your server, dropped off to
your server, or files returned to correct errors.
The OCSE standard naming conventions (in the chart below) must be used for the file names.
Note: Adobe Reader is the only PDF software compatible with e-NMSN.
You can skip to page 8 for Server Information.

Programming (System-to-System) File Information
Information for the following section is required if the Programming option is selected above.
Select e-NMSN file format:
The Part-A response file must be in the same format as the e-NMSN file
received. Flat files have a .txt file extension.
Select Part-B Response file format:
This field is required if an employer or third-party provider is returning
Part-B to OCSE.
Do you want a copy of the NMSN in PDF file format?
Yes

No

When you select a programming option above, you can also choose to
receive individual NMSN PDFs.

Error File
The file submitter will receive an error file for the following conditions:
•
•
•
•

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If there are problems with file header, file trailer, or other file-level structures, the entire file will be returned.
If errors are in the batch header or batch trailer, the entire batch will be returned with all response records.
If there are response record errors, the records with errors are returned in the file with their batch header
and trailers. There can be multiple batches returned in the file.
You will receive a daily “Processing Summary” of the files that have been picked up from your server, dropped
off to your server, or files returned to correct errors.

File Naming Convention
Files can be named using OCSE’s standard file naming convention or the organization’s file naming convention. The
naming convention for PDF files is standard for this process.
1.
2.

–
–

In the Standard/Organization-Supplied File Naming Convention column, select whether you want to use
your organization’s file naming convention or OCSE’s standard file naming convention.
In the File Naming Convention column, take the following steps:
If you are using your organization’s file naming convention, enter the file naming convention. For
example, for the file with notices (Incoming State Notice Files), you can enter enmsn.mybiz.notices.txt.
This is the name of the file you will receive that includes your notices.
If you are using OCSE’s standard file naming convention, an example file name is in the table below. For
more information about file naming conventions and formats, refer to the e-NMSN Software Interface
Specifications.

Server Information (Required for Both Options)
This information is required for the No Programming and Programming (System-to-System) file information.
•
•
•
•
•

Separate directory/folder names for file pick-up and file drop-off (must be different from those used for e-IWO).
This information is required for the production environment and optional for the test environment.
Server ID (may be the same as those used for e-IWO)
Server passwords
IP address
Host name is optional

The only methods offered for transferring e-NMSN data is for our servers to initiate the sending and retrieving of files
using SFTP or FTPS. We can only use FTPS with a partner's server that has our Certificate Authority (CA) installed, which
dedicates that server to exchanging files with our server using only FTPS.
File transfer preference: *
SFTP
FTPS

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Pick Up Server Information
Enter your organization’s server information for the e-NMSN server to retrieve files.
If you are receiving orders and using a third-party responder to respond to orders, skip this section.

Production Server User ID:

Test Server User ID:

Production Server Password:

Test Server Password:

Production Server IP Address:

Test Server IP Address:

Production Server Host Name:

Test Server Host Name:

Production Server Port:

Test Server Port:

Production Server Directory Name: *

Test Server Directory Name:

Drop-Off Server Information
Enter your organization’s server information for the e-NMSN server to deliver notices.
Production Server User ID:

Test Server User ID:

Production Server Password:

Test Server Password:

Production Server IP Address:

Test Server IP Address:

Production Server Host Name:

Test Server Host Name:

Production Server Port:

Test Server Port:

Production Server Directory Name: *

Test Server Directory Name:

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PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this voluntary information
collection is for OCSE to implement the electronic NMSN process and capture preferences for employers. Public reporting estimated
burden for this collection of information is 0.22 hours per respondent, including the time for reviewing instructions, gathering and
maintaining the data needed, and reviewing the collection of information. As provided by 42 U.S.C. § 653(m)(2), any confidential
information collected for this program is accessed only by authorized users. A federal agency may not conduct or sponsor an information
collection without a valid OMB Control Number. No individual or entity is required to respond to, nor shall an individual or entity be subject
to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act of 1995,
without a current valid OMB Control Number. If you have any comments on this collection of information, please contact
[email protected].

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