Terminating a NMSN

A New NMSN Is Required

To terminate a child(ren)'s coverage before the terms of the National Medical Support Notice (NMSN) are completed, a party must submit a new NMSN stating that the previous NMSN is terminated. This NMSN must be issued from the same state agency that sent the original NMSN and must contain the following information:

• The employee's name and Social Security Number
• The full name(s) of the child(ren) whose NMSN coverage is to be terminated and/or the case number that appears on the original NMSN
• A statement clearly indicating the original NMSN is terminated.

The state agency involved in the case may submit the completed NMSN form to:

Qualified Order Center
P.O. Box 299082
Lewisville, TX 75029-9082
Fax: (847) 442-0899

What Happens If Original NMSN Is Terminated

• Coverage under the NMSN will end for the eligible child(ren), according to a date determined by the employer based plan requirements.
• The Qualified Order Center will notify all people named in the NMSN and their designated representatives that the NMSN will be terminated.
• If the employee voluntarily covered the child(ren) under the health plan(s) before the NMSN, the eligible child(ren) will continue to be covered.

What Happens If Original NMSN Isn't Terminated

• The employee will remain obligated by the terms of the existing NMSN.
• The Qualified Order Center will notify all people named in the NMSN and their designated representatives that the NMSN is denied and enclose specific denial reasons.
• A revised NMSN requesting termination may be submitted by the same state agency that sent the original NMSN to:

  Qualified Order Center
  P.O. Box 299082
  Lewisville, TX 75029-9082
  Fax: (847) 442-0899

• A determination of the revised NMSN will be made 15 business days after it's received.