QMCSO/NMSN Requirements

What information must a medical child support order contain to be a “qualified” order?

A medical child support order must contain the following information in order to be qualified:

  • The name and last known mailing address of the participant and each alternate recipient. The order may substitute the name and mailing address of a State or local official for the mailing address of any alternate recipient;
  • A reasonable description of the type of health coverage to be provided to each alternate recipient (or the manner in which such coverage is to be determined) ; and
  • The period to which the order applies.

[ERISA § 609(a)(3)]

What is an “appropriately completed” National Medical Support Notice?

An “appropriately completed” Notice is a notice that includes the following information:

  • The name of an issuing State child support enforcement agency;
  • The name and mailing address of the employee, enrolled or eligible for enrollment, who is obligated by a State court or administrative order to provide medical support for each named child; and
  • The name and mailing address of each child covered by the Notice.
  • The name and address of a State or local official may be substituted for the address of the child.

A notice may be “appropriately completed” even if some items of information in the Notice are not included as long as the Notice includes the information listed above. In addition, if any of the necessary information described above has been omitted but is reasonably available to the plan administrator, the Notice should not fail to be “appropriately completed” solely because of such omission.

How does a National Medical Support Notice satisfy the QMCSO requirements?

An “appropriately completed” Notice satisfies the informational requirements of the QMCSO provisions by:

  • Providing the name and last known mailing address (if any) of the participant and the name and mailing address of each child covered by the order;
  • Having the child support enforcement agency identify either the specific type of coverage or all available group health coverage;
  • Instructing the plan administrator that if a Notice does not designate either specific type(s) of coverage or all available coverage, it should assume that all are designated, and further instructing the plan administrator that if a group health plan has multiple options and the participant is not enrolled, the agency will make a selection after the Notice is qualified and, if the agency does not respond within 20 business days, the child will be enrolled under the plan’s default option if there is one; and
  • Specifying that the period of coverage may end for the named child only when similarly situated dependents are no longer eligible for coverage under the terms of the plan, or upon the occurrence of events specified in the Notice.

A Notice also requires the plan to provide to a named child only those benefits that the plan provides to any dependent of a participant who is enrolled in the plan.

For more information on QMCSO/NMSN requirements, the US Department of Labor developed a comprehensive accessible resource “Qualified Medical Child Support Orders.”