View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0970-0222
ICR Reference No:
202509-0970-004
Status:
Active
Previous ICR Reference No:
202504-0970-026
Agency/Subagency:
HHS/ACF
Agency Tracking No:
OCSE
Title:
National Medical Support Notice - Part A
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
12/19/2025
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/16/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2028
36 Months From Approved
12/31/2025
Responses
19,181,513
0
9,771,527
Time Burden (Hours)
3,251,272
0
1,657,190
Cost Burden (Dollars)
0
0
0
Abstract:
The Office of Child Support Enforcement (OCSE) developed the National Medical Support Notice (NMSN) - Part A in accordance with the Child Support Performance and Incentives Act of 1998 and the Employee Retirement Income Security Act of 1974. The laws required OCSE to promulgate NMSN regulations, which were issued jointly by the Departments of Health and Human Services and Labor. The information collection activities associated with the NMSN are authorized by (1) 42 U.S.C. § 666, which requires all child support orders to include a provision for medical support, and where appropriate, enforced through the National Medical Support Notice; and (2) 29 U.S.C. § 1169, which provides for medical coverage pursuant to a qualified medical support order. The NMSN Part A is a standard, required form that child support agencies (CSAs) use to ensure employers enroll dependent children in available employer-sponsored medical coverage, if required by a child support order. The Department of Labor develops and maintains the required Part B form (OMB #: 1210-0113) that employers use to inform a plan administrator that a participant is obligated by an order to provide health care coverage for dependent children. This request is for a revision to the currently approved information collection. Please see A.15 of Supporting Statement A for an explanation about the changes.
Authorizing Statute(s):
US Code:
29 USC 1169
Name of Law: Additional standards for group health plans
US Code:
45 USC 303.32
Name of Law: National Medical Support Notice
PL:
Pub.L. 105 - 200 401(c) Section 609
Name of Law: Child Support Performance and Incentive Act
US Code:
42 USC 666
Name of Law: Requirement of statutorily prescribed procedures to improve effectiveness of child supp enforcement
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 26818
06/24/2025
30-day Notice:
Federal Register Citation:
Citation Date:
90 FR 44684
09/16/2025
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
9
IC Title
Form No.
Form Name
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) - 2026 Forward
1
National Medical Support Notice Part A
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) - Implementation Year
1
National Medical Support Notice Part A
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) - 2026 Forward
1
National Medical Support Notice Part A
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) - Implementation Year
1
National Medical Support Notice Part A
National Medical Support Notice-Part A (Employer Respondents) - 2026 Forward
1
National Medical Support Notice Part A
National Medical Support Notice-Part A (Employer Respondents) - Implementation Year
1
National Medical Support Notice Part A
National Medical Support Notice-Part A (State Respondents) - 2026 Forward
1
National Medical Support Notice Part A
National Medical Support Notice-Part A (State Respondents) - Implementation Year
1
National Medical Support Notice Part A
State Medical Support Contacts and Program Requirement Matrix (State Respondents) - Implementation Year
NMSN Matrix
State Medical Support Contacts and Program Requirement Matrix
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
19,181,513
9,771,527
0
9,409,986
0
0
Annual Time Burden (Hours)
3,251,272
1,657,190
0
1,594,082
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
OCSE removed the State Medical Support Contacts and Program Requirement Matrix, which constitutes a program change. This change resulted in only a minimal overall reduction in burden costs because of an increase in employee wages. The overall burden hour was reduced due to a decrease in state responses and a decrease in the number of employer respondents. The time per response remains the same.
Annual Cost to Federal Government:
$332,060
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.
Yes
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:
Molly Buck 202 205-4724 mary.buck@acf.hhs.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
09/16/2025
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