29 CFR 2590.609-2 National Medical Support Notice.
(a) This section promulgates the National Medical Support Notice (the Notice), as man-
dated by section 401(b) of the Child Support Performance and Incentive Act of 1998 (Pub. L.
105-200). If the Notice is appropriately completed and satises paragraphs (3) and (4) of section
609(a) of the Employee Retirement Income Security Act (ERISA), the Notice is deemed to be a
qualied medical child support order (QMCSO) pursuant to ERISA section 609(a)(5)(C). Section
609(a) of ERISA delineates the rights and obligations of the alternate recipient (child), the partici-
pant, and the group health plan under a QMCSO. A copy of the Notice is available on the Internet
*
at http://www.dol.gov/dol/pwba.
(b) For purposes of this section, a plan administrator shall nd that a Notice is appropri-
ately completed if it contains the name of an Issuing Agency, the name and mailing address (if
any) of an employee who is a participant under the plan, the name and mailing address of one or
more alternate recipient(s) (child(ren) of the participant) (or the name and address of a substituted
ocial or agency which has been substituted for the mailing address of the alternate recipient(s)),
and identifies an underlying child support order.
(c) (1) Under section 609(a)(3)(A) of ERISA, in order to be qualified, a medical
child support order must clearly specify the name and the last known mailing address
(if any) of the participant and the name and mailing address of each alternate recipient
covered by the order, except that, to the extent provided in the order, the name and mailing
address of an ocial of a State or a political subdivision thereof may be substituted for the
mailing address of any such alternate recipient. Section 609(a)(3)(B) of ERISA requires
a reasonable description of the type of coverage to be provided to each such alternate
recipient, or the manner in which such type of coverage is to be determined. Section 609(a)
(3)(C) of ERISA requires that the order specify the period to which such order applies.
(2) The Notice satises ERISA section 609(a)(3)(A) by including the
necessary identifying information described in Sec. 2590.609-2(b).
(3) The Notice satises ERISA section 609(a)(3)(B) by having the Issuing Agency
identify either the specic type of coverage or all available group health coverage. If an
employer receives a Notice that does not designate either specic type(s) of coverage or
all available coverage, the employer and plan administrator should assume that all are
designated. The Notice further satises ERISA section 609(a)(3)(B) by instructing the
plan administrator that if a group health plan has multiple options and the participant is not
enrolled, the Issuing Agency will make a selection after the Notice is qualied, and, if the
Issuing Agency does not respond within 20 days, the child will be enrolled under the plan’s
default option (if any).
(4) Section 609(a)(3)(C) of ERISA is satised because the Notice species that the period
of coverage may only end for the alternate recipient(s) when similarly situated dependents are no
longer eligible for coverage under the terms of the plan, or upon the occurrence of certain specied
events.
(d) (1) Under ERISA section 609(a)(4), a qualified medical child support order
may not require a plan to provide any type or form of benet, or any option, not otherwise
provided under the plan, except to the extent necessary to meet the requirements of a law
relating to medical child support described in section 1908 of the Social Security Act, 42
U.S.C. 1396g-1.
(2) The Notice satises the conditions of ERISA section 609(a)(4) because it
requires the plan to provide to an alternate recipient only those benets that the plan
provides to any dependent of a participant who is enrolled in the plan, and any other
benets that are necessary to meet the requirements of a State law described in such section
1908.
(e) For the purposes of this section, an “Issuing Agency” is a State agency that
administers the child support enforcement program under Part D of Title IV of the Social
Security Act.
*The current Web address is https://www.dol.gov/agencies/ebsa.
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