Form NMSN Matrix NMSN Matrix State Medical Support Contacts and Program Requirement M

State Medical Support Contacts and Program Requirements
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1.

2.

Information Requested

State Response

State/Territory Contact Information for Questions About NMSN:
Individual or group name:
Individual's title or group's department:
Agency name:
Direct telephone number:
Direct email address for individual or group:
Fax number (optional):
State’s website address (optional):
Medical Support Statutes
Please provide the statutory citations for the medical support laws of your state.

3.

Reasonable Cost Definition

Please select your state’s definition of "Reasonable Cost"

[Text from selection inserted here]

a) "Reasonable Cost" is defined by our state statute/agency policy. The definition is: __, and is
found here: ____
b) "Reasonable Cost" is not defined by our state statute/agency policy
c) Any health coverage available through the parent's employment is considered at a
"Reasonable Cost" unless adding the health coverage expense to all other ordered support
exceeds the federal Consumer Credit Protection Act (CCPA) limits

If you selected e, explain

d) Any health coverage available through the parent's employment is considered at a
"Reasonable Cost" unless the health coverage expense exceeds the CCPA limits
e) Other

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State Medical Support Contacts and Program Requirements
4.

Health Coverage Expense
To calculate whether the medical expense is under the limit of support to withhold, the
employer and plan administrator should use the plan expense which is:
a) the employee’s total cost of health coverage for the employee and child(ren), whether
the employee is already enrolled or not
b) the employee’s cost of health coverage for the employee + child(ren), less the cost of
employee-only coverage, whether the employee is already enrolled or not
c) the employee’s actual cost of adding this child(ren) to the employer's plan (may be
total costs for employee and children, if employee must now enroll, or it could be zero
if the employee already has dependent coverage)

Statute or policy citation

[Text from selection inserted here]

If you selected d, explain

d) other
5.

Income Withholding Limits for Support
This information is currently on the State Income Withholding Contacts and Program
Requirements Matrix on OCSE’s website, in the “Withholding limit(s) applied to payments
to employees” section. Please review the information on that matrix to ensure your
answers are consistent.
In your state statute or policy, what is the withholding limit used for medical support?
a) We calculate the available amount of disposable income for the aggregate of all
ordered support by applying either the CCPA withholding limits or_____ %, an agency
limit
b) We apply _____% of the employee’s gross income as the withholding limit for only
medical coverage

Statute or policy citation

[Text from selection inserted here]

If you selected c, explain

c) other

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State Medical Support Contacts and Program Requirements
6.

Priority of Withholding

This information is currently on the State Income Withholding Contacts and Program
Requirements Matrix on OCSE’s website, in the “Priority for withholding” section. Please review
the information on that matrix to ensure your answers are consistent.
Do you have a statute or policy that lists a priority of support to be paid through income
withholding?
a) If yes, list the priority of support to be paid from the parent's disposable earnings. (For
example, rank 1-5 starting with the superior priority: current child support, medical support,
current spousal support, arrears, interest)

Statute or policy citation

[Text from selection inserted here]

Rank priority of support

b) Other support to rank: (include other types of support to rank and assign appropriate
number)
7.

Priority of Health Coverage if the Income Withholding Limit Is
Less Than Total Costs of Ordered Coverage
Do you have a statute or policy that guides what an employer should do if the maximum amount
of allowable withholding is less than the sum of all ordered all health coverage?
If yes, provide the citation and select what an employer should do from the options below if
there are multiple health coverages ordered and to enroll the child(ren) in those coverages
would exceed the income withholding limits:

Statute or policy citation

[Text from selection inserted here]

a) Stop and not enroll the child(ren) in any coverage
b) Prioritize the types of coverage, and according to the priority, enroll the child(ren) in all
coverages (or a combination of coverages) that do not exceed the income withholding limits

If you selected b, rank priority of NMSN coverages

If you selected b, what is the priority of health coverage? (Rank 1-6 the NMSN coverages,
starting with superior priority: medical, dental, vision, prescription, mental health, other.)

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State Medical Support Contacts and Program Requirements
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State Options 45 CFR §303.32(a)
Did your state opt to enforce medical support against either or both parents, or only the
noncustodial parent?

[Text from selection inserted here]

a) Either or both parents
b) Only the noncustodial parent
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Employee Contests 45 CFR §303.32(c)(5)
If the employee wants to contest the NMSN withholding based on a mistake of fact,
describe how the employee should contact the agency and how to find any specific forms
to make the request.
THE PAPERWORK REDUCTION ACT OF 1995 (P.L. 104-13) Public reporting burden for this collection of information is estimated to average 1 hour per
response, including the time reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. OMB

control number: 0970-0222 Expiration Date: XX/XX/XXXX.

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