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OMB Control No: 1210-0113	ICR Reference No: 202508-1210-001
Status: Received in OIRA	Previous ICR Reference No: 202204-1210-005
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: National Medical Support Notice-Part B
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 11/25/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2025
Responses	10,753,708	19,352,287
Time Burden (Hours)	896,142	1,215,658
Cost Burden (Dollars)	5,927,982	6,400,769

Abstract: Pursuant to section 401(a) of the CSPIA, the Department of Labor (the Department) and HHS jointly promulgated the National Medical Support Notice Final Rule on December 27, 2000 (65 FR 82128) (NMSN Regulation). The NMSN Regulation simplifies the issuance and processing of medical child support orders; standardizes communication between State agencies, employers, and Plan Administrators; and creates a uniform and streamlined process for enforcement of medical child support to ensure that all eligible children receive the health care coverage to which they are entitled. The NMSN Regulation, codified at 29 CFR 2590.609-2, includes a model National Medical Support Notice (NMSN) that is comprised of two parts: part A is a notice from the State agency to the employer, entitled: “Notice to Withhold for Health Care Coverage;” and part B is a notice from the employer to the Plan Administrator, entitled: “Medical Support Notice to Plan Administrator.” Both parts have detailed instructions informing the recipient to whom responses are due depending on varying circumstances. This ICR addresses the Plan Administrator's responsibilities under NMSN Regulation to complete part B of the NMSN, the “Plan Administrator Response,” pursuant to the CSPIA and section 609(a)(5)(C) of title I of ERISA. The “Plan Administrator Response” in part B of the NMSN requires the Plan Administrator to provide information verifying whether the child is or will be receiving health care coverage from the group health plan. If enrollment has already occurred or can begin immediately, the Plan Administrator's response in part B serves as notice to the State agency, the participant (parent), the child, their non-participant parent or guardian and the employer that the child is or will begin receiving dependent health care coverage pursuant to the group health plan. When the child is eligible for more than one coverage option, the Administrator must first send the part B response to the State agency so that the agency may choose one option. The Plan Administrator must also use the part B response to notify all of the above-affected persons of any waiting period before enrollment of the child can occur.

Authorizing Statute(s): US Code: 29 USC 1169(a) Name of Law: Employee Retirement Income Security Act of 1974

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 671	01/06/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 53392	11/25/2025
Did the Agency receive public comments on this ICR? Yes

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
National Medical Support Notice - Part B

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	10,753,708	19,352,287	-8,598,579
Annual Time Burden (Hours)	896,142	1,215,658	-319,516
Annual Cost Burden (Dollars)	5,927,982	6,400,769	-472,787

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: In 2022, this information collection was revised to require an additional addendum for all states without e-NMSN. The costs to prepare these addendums were one-time costs, which will now be simply included with the overall notice. As a result, there is no separate cost for the addendum. This will substantially lower the costs associated with this information collection. Additionally, the Department has updated the plan data, health insurance data, wage rates, and material costs. The Department has also used an updated methodology to estimate the costs associated with mailing. As a result, the number of responses decreased by 8,598,579, the hour burden decreased by 319,516 hours, and the cost burden by $472,787.

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: James Butikofer 202 693-8434 Butikofer.James@dol.gov

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