Child Support Enforcement

The mission of Hancock County CSEA, is to operate a program for support enforcement in Hancock County that complies with both federal and state law and to provide all services relative thereto, in a courteous, professional manner.

National Medical Support Notice



1. Overview

2. National Medical Support Notice (NMSN)

3. I received a Notice of Medical Support Enforcement Activity, cialis what does this mean?

4. What if I disagree with the Notice of Medical Support Enforcement Activity?



1. Both Court and Administrative Child Support Orders must contain specific information related to the medical support of the child(ren). The CSEA is required to enforce all medical support orders for IV-D(Child Support) cases. Medical support services shall be provided by the CSEA for all OWF (Ohio Works First), IV-E (Foster Care) and Covered Families and Children Medicaid cases receiving Title XIX medical benefits. The signing of a Medicaid application or reapplication constitutes assignment to Child Support Services.

The CSEA must enforce support orders with health insurance coverage, or collect court ordered medical support or birth costs to reimburse Medicaid. None of the assigned support obligation dollars collected can be used to satisfy a medical support obligation unless the support order designates a specific dollar amount for medical purposes.

2. The National Medical Support Notice (NMSN) is a federally required tool used to enforce medical support orders for minor children. It is to be used throughout the United States to enroll children in employment-related health insurance coverage. Federal law requires all states to adopt laws requiring use of the NMSN, and Ohio has passed HB 657 for implementation in January, 2003.

The NMSN is only required for employment based insurance coverage. The NMSN must be generated and sent in response to new employment discovered through the New Hire reporting process or employment identified through other sources. The NMSN must be issued within two business days of a new hire match and is sent at the same time as the income withholding for other employment discoveries. The NMSN is sent to the employer of the party who has been ordered to provide the medical insurance.

The NMSN is a 14 page document with instructions for the employer and the health plan administrator. A description of the NMSN and the employer and Plan Administrator duties are described on the ODJFS/OCS Internet site at:

3. You have received this notice to inform you that the Hancock County CSEA has sent a copy of the NMSN (National Medical Support Notice) to your employer. The NMSN was sent to your employer because the CSEA has identified you as being ordered by the court to provide medical insurance for your child(ren).

4. You have a right to request an administrative mistake of fact hearing if you believe you are not the person named by the Notice, or if you have not been ordered to provide medical insurance for your child(ren). Complete and send in the last page of the Notice to the CSEA within 7 business days of the date of the Notice.

Please see additional information under OCDA Fact Sheets.