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  • Payroll

New Revision Date for National Medical Support Notice

Jennifer Weiss
By: Jennifer Weiss
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About the Author

Jennifer keeps readers current on Payroll news, covering topics such as employment taxes, fringe benefits and the Fair Labor Standards Act. She brings over 20 years of experience to the HRMorning staff.

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Last Updated: February 25, 2026
1 minute engagement

Be on the lookout for an updated notice, requiring you to provide healthcare coverage to an employee’s child.

As in the past, if you receive a National Medical Support Notice (NMSN), you’ll need to act promptly to enroll the child in your group health plan and start withholding premiums from the employee’s wages — regardless of whether it’s open enrollment time at your company.

The Office of Child Support Enforcement (OCSE) made only minor changes to the latest version of the NMSN. For example, the expiration date changed from November 30, 2025, to December 31, 2028 for both:

  • Part A, Notice to Withhold for Health Care Coverage, and
  • Part B, Medical Support Notice to Plan Administrator.

Seeking Detailed Info

Several websites, which allow employers to get detailed information, have changed on Part A and Part B.

On Part A, that includes the link to Supplemental Instructions for Employers, Employer Partners, and Child Support Agencies.

Given that questions on priority of withholding, for instance, would be best answered on the state level, Part A also includes the link to the state child support agency matrix.

What If Enrollment Isn’t Possible?

Also, the OCSE has revised some wording on Part A of the NMSN. It’s found at the top of page 3 where employers can indicate that enrollment isn’t possible and why.

The old form said: “The employer knows that the plan administrator cannot enroll dependents in employer-provided health care coverage for the employee named on page 1 because:” After that, the form provided a list of six reasons, with a directive to “select all that apply.”

However, the new form doesn’t include the step about choosing all that apply.

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