The electronic National Medical Support Notice (e-NMSN) is an efficient and cost-effective way for child support agencies to exchange NMSNs with employer partners (employers, third-party providers, plan administrators, and unions).

Benefits of using e-NMSN:
- Reduces errors from manual processing
- Supports virtual office environments;
- Reduces costs of postage and processing paper documents
- Allows employers to report employee terminations
- Allows states to notify employer partners that medical support is no longer ordered or enforced
- Allows employer partners to implement health coverage sooner
Find out more about the free e-NSMN service in this printable flyer (PDF).
How can an employer start using e-NMSN?
Employers must have secure servers and allow OCSS to drop off and pick up files (Parts A and B) in dedicated directories. The e-NMSN process went live in February 2022.
Resources:
What are the implementation options?
Two options:
Option 1 — No Programming
The No Programming option is ideal for employers that have limited IT resources or do not receive a large volume of NMSNs. We encourage employer partners who elect to use Option 2, System-to-System, to start with the No Programming option.
How it works:
- You receive an image-ready portable document format (PDF) copy of the NMSN with Parts A and B, as a fillable PDF.
- You complete the fillable fields on the PDF Part A or Parts A and B, as appropriate. OCSS picks up the completed NMSN forms and delivers them to the issuing child support agency.
- If you have a third-party provider (TPP) who completes Part A or Parts A and B on your behalf, you may use your existing process to send the PDF version of the NMSNs to your provider. The TPP may also enroll in e-NMSN and receive the notices directly.
- Since e-NMSN is based on the paper notice, you may use e-NMSN’s Part A to notify a child support agency why the employer is not able to enroll the child(ren) and to report employment terminations. You may also electronically attach plan information to Part B.
The No Programming option requires no programming and minimal effort from your IT department to configure a server and directories.
If you are already using the OCSS electronic income withholding order (e-IWO) process, you may use the same server for e-NMSN.
If you choose to use the same server, you must have separate drop-off and pick-up directories (folders) for e-IWO and e-NMSN.
For more information about this option, please visit the e-NMSN Software Interface Specification webpage.
Option 2 — System-to-System
The System-to-System option is ideal for medium to large employers, professional employer organizations, third-party processers, or plan administrators seeking to fully automate the process to receive e-NMSNs and respond to Parts A and B without manual processing.
How it works:
- OCSS sends NMSNs Parts A and B to you in your choice of a flat file or XML format. (You may elect to also receive an image-ready PDF copy of the NMSN along with your file selection.)
- You process the electronic records and create a response for Part A or Parts A and B.
- If you have a TPP, who completes Part A or Parts A and B on your behalf, you may use your existing process to send the PDF version of the NMSNs to your provider. The TPP may also enroll in e-NMSN and receive the notices directly.
- Since e-NMSN is based on the paper notice, you may use e-NMSN’s Part A to notify a child support agency why the employer is not able to enroll the child(ren) and to report employment terminations. You may also electronically attach plan information to Part B.
The System-to-System option requires some programming and effort from your IT department to map data elements to the record layout, configure a server and directories, and establish connectivity. If you already use our e-IWO process, you may use the same server for e-NMSN. If you choose to use the same server, you must have separate drop-off and pick-up directories (folders) for e-IWO and e-NMSN. Child support agencies must use the System-to-System option.
For more information about this option, please visit the e-NMSN Software Interface Specification webpage.
How do I register for e-NMSN?
Complete one or both e-NMSN profile forms and email to e-NMSNmail@acf.hhs.gov.