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pdfOMB Control No: 0970-0370
Expiration Date: 02/28/2025
Department of Health and Human Services
Administration for Children and Families
Office of Child Support Enforcement
Agreement to Exchange Electronic
National Medical Support Notices
By completing and providing the information included in the Electronic National Medical Support Notice (e-NMSN)
Employer Profile Form, the employer or third-party provider agrees that:
The employer, company, or government agency shall have appropriate procedures in place
to promptly report confirmed and suspected information security or privacy incidents, including, but
not limited to, unauthorized use or disclosure of Personally Identifiable Information (PII)
involving confidential child support information submitted through OCSE to your organization.
As soon as reasonably practicable after discovery, but in no case later than one hour after
discovery of the incident, the employer, company, or government agency shall report
confirmed or suspected incidents to OCSE as specified in this paragraph. The requirement for
the employer, company, or government agency to report confirmed or suspected incidents
involving PII to OCSE is based on federal guidance/requirements from the Office of
Management and Budget (OMB), Health and Human Services (HHS), the Federal Information
Security Modernization Act of 2014 (FISMA), and the United States Computer Emergency Readiness
Team (US-CERT).
Incidents must be reported via email to OCSE using the security mailbox address:
ocsesecurity@acf.hhs.gov.
The organization will electronically receive and respond to NMSNs issued by states, tribes, or
territories in the same manner as mailed notices within the required timeframes. Response
timeframes and other instructions are available at https://www.acf.hhs.gov/css/form/nationalmedical-support-notice-forms-instructions.
The organization will not impersonate any individual, entity, or association; use false headers; or
otherwise conceal or provide misleading information about their identity while receiving NMSNs
electronically.
The organization’s representative completing this form is authorized to act on behalf of the employer
and agrees to provide true, correct, current, and complete information about the entity identified in
the profile form.
The organization will consider the electronic version of the NMSN admissible as evidence in the same
way as paper documents.
The organization will provide written notice to the federal Office of Child Support Enforcement at least
30 days before it intends to stop accepting e-NMSNs.
A third-party provider certifies that it has authorization to participate in e-NMSN on behalf of their
clients and will provide company names, FEINs, and related information to OCSE for the purpose of
processing e-NMSNs.
Accept
Decline
Page 1
e-NMSN Employer/Third-Party Provider Profile
Instructions
To complete this form and to respond to NMSNs using PDF forms, you must use Adobe Acrobat Reader
version 10 or later. To download this free software, go to https://acrobat.adobe.com/us/en/acrobat/pdfreader.html.
You must complete the required fields followed by a red asterisk * and email it to the e-NMSN team
(eNMSNmail@acf.hhs.gov). If there are errors, a popup box will appear with information about
correcting the error.
Employers:
• Register as an employer with this form.
•
If applicable, use the e-NMSN FEINs Spreadsheet to identify each subsidiary for which you will
receive e-NMSNs at the server location entered on this form.
•
Provide Part-A responses on the Pick-Up server.
•
Provide Part-B responses, when applicable, on the Pick-Up server.
•
If you are using an external plan administrator, forward Part-B to the external plan
administrator.
•
If the NMSN is for an employee whose health insurance is through a union or labor
organization, forward Part-B to the union or labor organization. If you are receiving e-NMSN
orders and using a third-party responder to send responses back to states, it is your
responsibility to forward the orders and encourage the third-party responder to register with
the e-NMSN system.
Third-Party Providers (Processing e-NSMNs on Behalf of Clients):
•
If you will receive and respond to orders, register as a third-party provider using this form.
•
If you will only respond to orders, do not continue to use this version of the Profile form.
Instead, use the Plan Administrator Profile form and register as Third Party: Responder Only.
Use the e-NMSN FEINs Spreadsheet to identify each employer and, if applicable, their
subsidiaries for whom you will process e-NMSNs.
•
Provide Part-A responses on the Pick-Up server.
•
Provide Part-B responses, when applicable, on the Pick-Up server.
•
If the NMSN is for an employee whose health insurance is through a union or labor
organization, forward Part- B to the union or labor organization. Professional employer
organizations that want to receive e-NMSNs on behalf of employers must complete the profile
form as a third-party provider and use the e-NMSN FEINs spreadsheet to list the FEINs for the
employer(s) and any subsidiaries.
Note: Third-party providers, professional employer organizations, plan administrators, or unions
that want to receive e-NMSNs for their own employees must register as an employer.
Page 2
General Information
Date: *
(The date you are completing the form using MM/DD/YYYY format.)
FEIN: *
Organization Type: *
(Primary Federal Employer Identification Number – enter as nine numeric characters with no hyphen
after the second number. This is the FEIN used for the files being transferred.)
If you select Employer, provide the FEINs spreadsheet with information for your primary organization
and any subsidiaries.
If you select Third Party, provide the FEINs spreadsheet with client information including employers and
subsidiaries.
Organization Name: *
Organization Known as Name (Doing Business As):
Address Information
Enter the employer or third-party provider’s address where child support agencies should mail paper NMSNs.
Address Line 1: *
Address Line 2:
City: *
ZIP Code: *
State: *
ZIP Code Extension:
(Enter a five-digit ZIP code and the optional four-digit extension.)
Is this also the address for mailing Income Withholding for Support Orders (IWOs)?
Yes
No
Page 3
Contact Information
Enter the organization’s business, technical support, and alternate contact information.
Note: At least one person must be designated to received automated emails.
Business Contact Information
Enter business contact information for working with OCSE to set up e-NMSN and assist with issue resolution.
First Name: *
MI:
Last Name: *
Email: *
Send email notifications, including file processing information, to this email address.
Phone Number: *
Fax Number:
Phone Ext:
(Enter numeric characters
only. Include the area code.
Format: 1231231111)
(Enter numeric characters
only. Include the area code.
Format: 1231231111)
Technical Contact Information
Enter the network or system administrator who can provide corporate Internet Protocol (IP) address information and
batch system information.
First Name: *
MI:
Last Name: *
Email: *
Send email notifications, including file processing information, to this email address.
Phone Number: *
Fax Number:
(Enter numeric characters
only. Include the area code.
Format: 1231231111)
Phone Ext:
(Enter numeric characters
only. Include the area code.
Format: 1231231111)
Page 4
Alternate Business Contact Information
Enter additional business contact information for working with OCSE to set up e-NMSN and assist with issue
resolution. None of the fields are required.
First Name:
MI:
Last Name:
Email:
Send email notifications, including file processing information, to this email address.
Phone Ext:
Phone Number:
Fax Number:
(Enter numeric characters only.
Include the area code. Format:
1231231111)
(Enter numeric characters only.
Include the area code. Format:
1231231111)
Alternate Technical Contact Information
Enter additional technical contact information network or system administrator who can provide corporate Internet
Protocol (IP) address information and batch system information. None of the fields are required.
First Name:
MI:
Last Name:
Email:
Send email notifications, including file processing information, to this email address.
Phone Number:
Fax Number:
Phone Ext:
(Enter numeric characters only.
Include the area code. Format:
1231231111)
(Enter numeric characters only.
Include the area code. Format:
1231231111)
Page 5
File Information
Review the default selections below and make updates as needed, based on the best option for your organization.
General File Information
Enter information about the file exchange.
Encrypt files: *
Yes
No
Select Yes if you want OCSE to encrypt all files delivered to your server.
OCSE uses GPG for encryption.
If you select Yes, you must provide your company’s PGP or GPG
encryption key in a separate email when sending this profile.
Are your files stored behind your organization firewall?
Yes
No
This field is required only if you selected No for the Encrypt files option.
If you are an employer or third-party provider, you are responsible for completing Part-A for OCSE to pick up and
forwarding Part-B to your organization’s plan administrator or a union, if it is acting as a plan administrator.
Are you receiving e-NMSNs and forwarding both Part-A and-Part B to a third-party responder for processing and
responding?
Yes
No
If you select Yes, we encourage you to have the third-party responder create a profile to use the e-NMSN system.
Until the third-party responder is participating in e-NMSN, it is the employer’s responsibility to forward the
NMSN orders to the third-party responder and receive them back to place on the employer’s Pick-Up server for OCSE.
If you selected No, who will return Part-B of the e-NMSN response?
Employer or Third-party Provider
Plan Administrator and/or Union
If you selected Plan Administrator and/or Union, complete the e-NMSN FEINs spreadsheet, including the Plan
Administrators tab, and return it with this form.
Note: If you are an employer or third-party provider and are using an external plan administrator to respond to Part-B of
the NMSN, encourage them to participate in e-NMSN.
File Processing Information
How do you want to receive and respond to e-NMSNs?
Programming
(System-to-System)
No Programming
(PDF format)
Programming and No Programming Option information is listed next.
Page 6
No Programming File Information
You will receive the NMSN and Parts A and B in PDF format.
You will receive a daily “Processing Summary” of the files picked up from your server, dropped off to your server, or
returned to correct errors.
The OCSE standard naming conventions (on page 8) must be used for the file names.
Note: Adobe Reader is the only PDF software compatible with e-NMSN.
Skip to page 8 for Server Information.
•
•
•
•
•
Programming (System-to-System) File Information
Information for the following section is required if the Programming option selected on page 6.
Select e-NMSM file format:
Flat file
The Part-A response file must be in the same format as the
e-NMSN file received. Flat files have a .txt file extension.
XML
Select Part-B Response file format:
Flat file
This field is required if an employer or third-party provider is
returning Part-B to OCSE.
XML
Do you want a copy of the NMSN in PDF file format?
Yes
No
When you select a programming option above, you can also
choose to receive individual NMSN PDFs.
Error File
The file submitter will receive an error file for the following conditions:
•
•
•
•
If there are problems with file header, file trailer, or other file-level structures, the entire file will be returned.
If errors are in the batch header or batch trailer, the entire batch will be returned with all response records.
If there are response record errors, the records with errors are returned in the file with their batch header and
trailers. Multiple batches can be returned in the file.
You will receive a daily “Processing Summary” of the files picked up from your server, dropped off to your server, or
returned to correct errors.
Page 7
File Naming Convention
Files can be named using OCSE’s standard file naming convention or the organization’s file naming convention. The
naming convention for PDF files is standard for this process:
1. In the Standard/Organization-Supplied File Naming Convention column, select whether you want to use your
organization’s file naming convention or OCSE’s standard file naming convention.
2. In the File Naming Convention column, take the following steps:
– If you are using your organization’s file naming convention, enter the file naming convention. For example, for
–
the file with notices (Incoming State Notice Files), you can enter
enmsn.mybiz.notices.txt. This is the name of the file you will receive that includes your notices.
If you are using OCSE’s standard file naming convention, an example file name is in the table below. For more
information about file naming conventions and formats, refer to the e-NMSN Software Interface
Specifications.
File Type
Incoming State Notice Files *
Standard/Organization-Supplied
File Naming Convention
OCSE Standard
File Naming
Convention
(Example: 123456789.
ENM.200708060115087.0000.txt)
Organization-Supplied
Outgoing Part-A Response Files *
OCSE Standard
(Example: 123456789.
ARF.200708060115087.0000.txt)
Organization-Supplied
Outgoing Part-B Response Files
OCSE Standard
This field is required if you are returning
the Part-B responses.
(Example: 123456789.
BRF.200708060115087.0000.txt)
Organization-Supplied
Server Information (Required for Both Options)
This information is required for the No Programming and Programming (System-to-System) file information.
• Separate directory/folder names for file Pick-Up and file Drop-Off (must be different from those used for e-IWO).
This information is required for the production environment and optional for the test environment.
• Server ID (may be the same as those used for e-IWO).
• Server passwords.
• IP address.
• Host name is optional.
The only methods offered for transferring e-NMSN data is for our servers to initiate the sending and retrieving of
files using SFTP or FTPS. We can only use FTPS with a partner's server that has our Certificate Authority (CA)
installed, which dedicates that server to exchanging files with our server using only FTPS.
File transfer preference: *
SFTP
FTPS
Page 8
Pick-Up Server Information
If you are receiving orders and using a third-party responder to respond to orders, skip this section.
Enter your organization’s server information for the e-NMSN server to retrieve files.
Production Server User ID:
Test Server User ID:
Production Server Password:
Test Server Password:
Production Server IP Address:
Test Server IP Address:
Production Server Host Name:
Test Server Host Name:
Production Server Port:
Test Server Port:
Production Server Directory Name: *
Test Server Directory Name:
Drop-Off Server Information
Enter your organization’s server information for the e-NMSN server to deliver notices.
Production Server User ID:
Test Server User ID:
Production Server Password:
Test Server Password:
Production Server IP Address:
Test Server IP Address:
Production Server Host Name:
Test Server Host Name:
Production Server Port:
Test Server Port:
Production Server Directory Name: *
Test Server Directory Name:
Page 9
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this voluntary information collection is for OCSE
to implement the electronic NMSN process and capture preferences for employers. Public reporting estimated burden for this collection of information
is 0.22 hours per respondent, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of
information. As provided by 42 U.S.C. § 653(m)(2), any confidential information collected for this program is accessed only by authorized users. A federal
agency may not conduct or sponsor an information collection without a valid OMB Control Number. No individual or entity is required to respond to, nor
shall an individual or entity be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork
Reduction Act of 1995, without a current valid OMB Control Number. If you have any comments on this collection of information, please contact
OCSEFedSystems@acf.hhs.gov.
Page 10
File Type | application/pdf |
File Title | e-NMSN Employer Profile Form |
Subject | e-NMSN, Profile Form |
Author | Office of Child Support Enforcement |
File Modified | 2022-07-22 |
File Created | 2020-12-23 |