Medical Support Notices


A National Medical Support Notice (NMSN) is a court order to enroll the dependent(s) in an employer-provided health insurance plan (medical, dental, and vision) if available at no or a reasonable cost. Under California Law (SB580), a plan is determined to be offered at a reasonable cost if the difference in the cost for coverage for the employee only and the cost for the coverage for the employee plus the dependent(s) does not exceed 5% of the employee’s gross income. If the cost is not reasonable per California Law or if the cost plus the child support IWO exceed 50% of the employee’s disposable earnings please return the Employer Response page of the NMSN indicating as such. Take no action regarding adding the dependent(s) to the medical insurance unless instructed further by our agency.


If the cost is reasonable your responsibility as an employer is to begin or maintain coverage for the employee's dependent(s) whose names are listed on the order. Note that the NMSN is not subject to an open enrollment period for implementation.  Please follow the instructions included with each NMSN. A copy of the NMSN must also be given to the employee. A response must be received by DCSS within ninety (90) days of service. If the dependents are already covered through your company's plan, return the NMSN with the required information. If coverage is available, please enroll the dependent(s) and return to our office a completed Plan Administrator Response, the Health Insurance Information pages providing the policy information, and any insurance cards and/or booklets. If coverage will be available at a later date, please complete the Plan Administrator Response page and return it indicating the date insurance will be available. When the insurance becomes available, please enroll the dependent(s) and respond per the instructions above.  If at a later time the coverage lapses it is the employer’s responsibility to notify DCSS.

If you do not provide health insurance to your employees please return the Employer Response page checking box 2 to indicate you do not offer coverage.
If the employee is subject to a waiting period before they are eligible for coverage (probation) please return the Employer Response page checking box 6 and indicate the date the waiting period will expire.

If the employee is no longer employed or has never been employed return the Employer Response page checking box 1.

Failure to comply with an NMSN is a crime and the employer can be held liable for medical costs incurred during the time the insurance should have been in place in addition to civil penalties for contempt.