National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents)

National Medical Support Notice - Part A

2023_08_23_e-NMSN_Software_Interface_Specification_Appendix_C_V1_6_DRAFT

National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents)

OMB: 0970-0222

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Operations, Maintenance, and Enhancements for OCSS Systems

Electronic National Medical Support Notice

Appendix C

Software Interface Specification

Version 1.6

August 23, 2023

Administration for Children and Families

Office of Child Support Services

330 C Street SW, 5th Floor

Washington, DC 20201

Revision History

Date

Revision

Section

Author

3/29/2021

v1.0: Original release

Entire document

H. Rallapalli

6/29/2021

v1.1: Minor updates

Chart C-2: Updated FEIN Text field

H. Rallapalli

8/18/2021

v1.2: Minor updates

No changes to Appendix C

H. Rallapalli

1/31/2022

v1.3: Minor updates

Chart C-2: Added validation rules to the following fields:

  • Issuing Agency Name

  • Court or Administrative Authority Name

  • Employer Name

  • Substituted Official/Agency Name

H. Rallapalli

4/20/2022

v1.4: Minor Updates


M. Stanczyk

1/27/2023

v1.5: Split document body and appendices into separate files

Entire document

J. Vierow

8/23/2023

V1.6: Field changes

Chart C-1: The Filler field length increased and the location changed.

Chart C-2: The following changes were made:

  • The Withholding Prioritization Text was removed.

  • The following fields were added:

    • Issuing Agency Email Address

    • Child 7 Last Name

    • Child 7 First Name

    • Child 7 Middle Name or Initial

    • Child 7 Suffix Text

    • Child 7 Gender

    • Child 7 Date of Birth

    • Child 7 SSN

    • Child 8 Last Name

    • Child 8 First Name

    • Child 8 Middle Name or Initial

    • Child 8 Suffix Text

    • Child 8 Gender

    • Child 8 Date of Birth

    • Child 8 SSN

    • Child 4 Last Name to be Terminated Health Care Coverage

    • Child 4 First Name to be Terminated Health Care Coverage

    • Child 4 Middle Name or Initial to be Terminated Health Care Coverage

    • Child 4 Suffix Name to be Terminated Health Care Coverage

    • Child 4 Date of Birth to be Terminated Health Care Coverage

    • Child 5 Last Name to be Terminated Health Care Coverage

    • Child 5 First Name to be Terminated Health Care Coverage

    • Child 5 Middle Name or Initial to be Terminated Health Care Coverage

    • Child 5 Suffix Name to be Terminated Health Care Coverage

    • Child 5 Date of Birth to be Terminated Health Care Coverage

    • Child 6 Last Name to be Terminated Health Care Coverage

    • Child 6 First Name to be Terminated Health Care Coverage

    • Child 6 Middle Name or Initial to be Terminated Health Care Coverage

    • Child 6 Suffix Name to be Terminated Health Care Coverage

    • Child 6 Date of Birth to be Terminated Health Care Coverage

    • Child 7 Last Name to be Terminated Health Care Coverage

    • Child 7 First Name to be Terminated Health Care Coverage

    • Child 7 Middle Name or Initial to be Terminated Health Care Coverage

    • Child 7 Suffix Name to be Terminated Health Care Coverage

    • Child 7 Date of Birth to be Terminated Health Care Coverage

    • Child 8 Last Name to be Terminated Health Care Coverage

    • Child 8 First Name to be Terminated Health Care Coverage

    • Child 8 Middle Name or Initial to be Terminated Health Care Coverage

    • Child 8 Suffix Name to be Terminated Health Care Coverage

    • Child 8 Date of Birth to be Terminated Health Care Coverage

  • The Filler field length increased and the location changed.

  • Field locations were updated because of the deleted and added fields.

Chart C-3: The Filler field length increased and the location changed.

M. Stanczyk

List of Charts






              1. e-NMSN Request Record Layouts

Chart C‑1 contains the e‑NMSN Request Header Record layout.

Chart C‑1: e-NMSN Request Header Record Layout

Field Name

Length

Location

A/N

Comments

Record Identifier

4

1–4

A

Required.

The letters ENRH, which identify the record as a request header.

Employer FEIN

9

5–13

N

Required.

Employer FEIN.

Third-party FEIN

9

14–22

N

Optional.

FEIN of the third-party provider that will respond on behalf of the employer.

Fill with spaces if the state does not know the FEIN of the third-party provider.

FIPS Code

2

23–24

N

Required.

The two-digit locator code of the requesting state.

Processing Date

8

25–32

N

Required.

The date the header was generated.

Must be in CCYYMMDD format.

Creation Time

6

33–38

N

Required.

The time the header was generated.

Must be a valid time in HHMMSS format.

Batch ID

6

39–44

A/N

Required.

A unique identifier for each batch sent to the Portal daily. Use the unique batch ID only once per day.

Left-justified and padded with spaces to the right.

Portal Error Code(s)

49

45–93

A/N

For Portal use.

Generated when the Portal performed its validation and found errors. Header records with errors return the entire batch. The returned batch contains all requests originally sent.

Valid values:

DRVF – Detail Record Validation Failed

DBCN – Duplicate Batch Control Number

BHCR – Invalid data in a conditionally-required field

SPDE – State Profile Does Not Exist

EPDE – Employer Profile Does Not Exist

BHRF – Required field validation error

Each code is separated by a comma.

Left-justified and padded with spaces to the right.

Filler

2677

94–2770

A/N

This field is for future versions. For this version, fill with spaces.

Chart C‑2 contains the e‑NMSN Request Record layout.

Chart C‑2: e-NMSN Request Record Layout

Field Name

Length

Location

A/N

Comments

Record Identifier

4

1–4

A

Required.

The letters ENRD, which identify the record as a request detail.

Order Type

4

5–8

A

Required.

A code that indicates the type of NMSN order.

Valid values:

ORIG – Original: new order for the submitted case identifier by the submitting state

TERM – Termination: closure of an order; termination of insurance for the submitted case identifier by the submitting state

Notice Date

8

9–16

N

Required.

Date the NMSN was generated by the state in CCYYMMDD format.

CSE Agency Case Identifier

15

17–31

A/N

Required.

A value assigned by a state to uniquely identify each IV-D case in the state.

Issuing Agency Name

57

32–88

A/N

Required.

Name of the child support agency issuing the NMSN order.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Commas (,)

Periods (.)

Spaces

The first character cannot be a space.

Issuing Agency Address Line 1 Text

25

89–113

A/N

Required.

The street address of the child support agency issuing the NMSN.

Issuing Agency Address Line 2 Text

25

114–138

A/N

Optional.

The street address of the child support agency issuing the NMSN.

Issuing Agency Address Line 3 Text

25

139–163

A/N

Optional.

The street address of the child support agency issuing the NMSN.

Issuing Agency Address City Name

22

164–185

A/N

Required.

The city of the child support agency issuing the NMSN.

Issuing Agency Address State Code

2

186–187

A

Required.

The state code of the child support agency issuing the NMSN.

Issuing Agency Address ZIP Code

5

188–192

N

Required.

The ZIP code of the child support agency issuing the NMSN.

Issuing Agency Address ZIP Code Extension

4

193–196

N

Optional.

The ZIP code extension of the child support agency issuing the NMSN.

Issuing Agency Phone Number

10

197–206

N

Required.

The phone number of the organization issuing the NMSN.

Issuing Agency

Email Address

65

207–271

A/N

Required.

The email address of the organization issuing the NMSN.

Valid special characters:

Hyphens (-)

Underscore (_)

Periods (.)

At sign (@)

The first character cannot be a space.

Issuing Agency Fax Number

10

272–281

N

Optional.

The fax number of the organization issuing the NMSN.

Court or Administrative Authority Name

57

282–338

A/N

Required.

The name of the court or administrative authority in the state that issued the NMSN.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Commas (,)

Periods (.)

Spaces

The first character cannot be a space.

Court Order Date

8

339–346

N

Required.

The date generated by the state that the court ordered the employee or NCP to get medical insurance/coverage

Must be in CCYYMMDD format.

Order Identifier

30

347–376

A/N

Optional.

A unique identifier associated with a specific child support obligation in a case.

Document Tracking Identifier

30

377–406

A/N

Required.

A unique number assigned to assist with tracking of a notice through its complete “round trip” from the state to the employer or plan administrator and back to the state.

The document tracking identifier sent to the Portal must be unique for the files received the same day.

State Agency Employer Web Site Text

50

407–456

A/N

Optional.

The URL for a state child support agency’s employer section of its website.

If this field is filled, it must begin with http:// or https://.

FEIN Text

9

457–465

N

Required.

Employer FEIN.

The FEIN in this field must match the employer FEIN in the batch header.

Employer Name

57

466–522

A/N

Required.

Name of the employer.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Commas (,)

Periods (.)

Spaces

The first character cannot be a space.

Employer Address Line 1 Text

25

523–547

A/N

Required.

The street address of the employer.

Employer Address Line 2 Text

25

548–572

A/N

Optional.

The street address of the employer.

Employer Address Line 3 Text

25

573–597

A/N

Optional.

The street address of the employer.

Employer Address City Name

22

598–619

A/N

Required.

The city of the employer.

Employer Address State Code

2

620–621

A

Required.

The state code of the employer.

Employer Address Zip Code

5

622–626

N

Required.

The ZIP code of the employer.

Employer Address ZIP Code Extension

4

627–630

N

Optional.

The ZIP code extension of the employer.

Custodial Parent’s Last Name

20

631–650

A/N

Conditionally required; either the custodial parent’s (CP’s) last name or the name of the substituted official or agency is required.

The CP’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Custodial Parent’s First Name

15

651–665

A/N

Conditionally required; must be filled if the CP’s last name is provided.

The CP’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Custodial Parent’s Middle Name or Initial

15

666–680

A/N

Optional.

The CP’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Name Suffix

4

681–684

A/N

Optional.

The CP’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Custodial Parent Address Line 1 Text

25

685–709

A/N

Conditionally required; must be filled if the CP’s last name is provided.

The street address of the CP.

Custodial Parent Address Line 2 Text

25

710–734

A/N

Optional.

The street address of the CP.

Custodial Parent Address Line 3 Text

25

735–759

A/N

Optional.

The street address of the CP.

Custodial Parent Address City Name

22

760–781

A/N

Conditionally required; must be filled if the CP’s last name is provided.

The city of the CP.

Custodial Parent Address State Code

2

782–783

A

Conditionally required; must be filled if the CP’s last name is provided.

The state code of the CP.

Custodial Parent Address ZIP Code

5

784–788

N

Conditionally required; must be filled if the CP’s last name is provided.

The ZIP code of the CP.

Custodial Parent Address ZIP Code Extension

4

789–792

N

Optional.

The ZIP code extension of the CP.

Children Address Line 1 Text

25

793–817

A/N

Optional.

The street address of the children.

Children Address Line 2 Text

25

818–842

A/N

Optional.

The street address of the children.

Children Address Line 3 Text

25

843–867

A/N

Optional.

The street address of the children.

Children Address City Name

22

868–889

A/N

Conditionally required; must be filled if the Children Address Line 1 field is provided.

The city of the children.

Children Address State Code

2

890–891

A

Conditionally required; must be filled if the Children Address Line 1 field is provided.

The state code of the children.

Children Address ZIP Code

5

892–896

N

Conditionally required; must be filled if the Children Address Line 1 field is provided.

The ZIP code of the children.

Children Address ZIP Code Extension

4

897–900

N

Optional.

The ZIP code extension of the children.

Representative Last Name

20

901–920

A/N

Optional.

The last name of the children’s agent or guardian.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Representative First Name

15

921–935

A/N

Conditionally required; must be filled if the last name of the representative is provided.

The first name of the children’s agent or guardian.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Representative Middle Name or Initial

15

936–950

A/N

Optional.

The middle name or initial of the children’s agent or guardian.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Representative Name Suffix

4

951–954

A/N

Optional.

The representative’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Fill with spaces if no suffix name is available.

Representative Address Line 1 Text

25

955–979

A/N

Conditionally required; must be filled if the last name of the representative is provided.

The street address of the representative.

Representative Address Line 2 Text

25

980–1004

A/N

Optional.

The street address of the representative.

Representative Address Line 3 Text

25

1005–1029

A/N

Optional.

The street address of the representative.

Representative Address City Name

22

1030–1051

A/N

Conditionally required; must be filled if the last name of the representative is provided.

The city of the representative.

Representative Address State Code

2

1052–1053

A

Conditionally required; must be filled if the last name of the representative is provided.

The state code of the representative.

Representative Address ZIP Code

5

1054–1058

N

Conditionally required; must be filled if the last name of the representative is provided.

The ZIP code of the representative.

Representative Address ZIP Code Extension

4

1059–1062

N

Optional.

The ZIP code extension of the representative.

Representative Phone Number

10

1063–1072

N

Conditionally required; must be filled if the last name of the representative is provided.

The phone number of the representative.

Employee’s Last Name

20

1073–1092

A/N

Required.

The employee’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Employee’s First Name

15

1093–1107

A/N

Required.

The employee’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Employee’s Middle Name or Initial

15

1108–1122

A/N

Optional.

The employee’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Employee’s Name Suffix

4

1123–1126

A/N

Optional.

The employee’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Employee SSN

9

1127–1135

N

Required.

The employee’s Social Security number (SSN).

Employee Address Line 1 Text

25

1136–1160

A/N

Optional.

The street address of the employee.

Employee Address Line 2 Text

25

1161–1185

A/N

Optional.

The street address of the employee.

Employee Address Line 3 Text

25

1186–1210

A/N

Optional.

The street address of the employee.

Employee Address City Name

22

1211–1232

A/N

Conditionally required; must be filled if line 1 of the employee’s address is provided.

The city of the employee.

Employee Address State Code

2

1233–1234

A

Conditionally required; must be filled if line 1 of the employee’s address is provided.

The state code of the employee.

Employee Address ZIP Code

5

1235-1239

N

Conditionally required; must be filled if line 1 of the employee’s address is provided.

The ZIP code of the employee.

Employee Address ZIP Code Extension

4

1240 –1243

N

Optional.

The ZIP code extension of the employee.

Substituted Official/Agency Name

57

1244–1300

A/N

Conditionally required; either the CP’s last name or the name of the substituted official or agency is required.

The name of the substituted official or agency.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Commas (,)

Periods (.)

Spaces

The first character cannot be a space.

Substituted Official/Agency Address Line 1 Text

25

1301–1325

A/N

Conditionally required; must be filled if the name of the substituted official or agency is provided.

The street address of the substituted official or agency.

Substituted Official/Agency Address Line 2 Text

25

1326–1350

A/N

Optional.

The street address of the substituted official or agency.

Substituted Official/Agency Address Line 3 Text

25

1351–1375

A/N

Optional.

The street address of the substituted official or agency.

Substituted Official/Agency Address City Name

22

1376–1397

A/N

Conditionally required; must be filled if the Substituted Official/Agency Name field is provided.

The city of the substituted official or agency.

Substituted Official/Agency Address State Code

2

1398–1399

A

Conditionally required; must be filled if the Substituted Official/Agency Name field is provided.

The state code of the substituted official or agency.

Substituted Official/Agency Address ZIP Code

5

1400–1404

N

Conditionally required; must be filled if the Substituted Official/Agency Name field is provided.

The ZIP code of the substituted official or agency.

Substituted Official/Agency Address ZIP Code Extension

4

1405–1408

N

Optional.

The ZIP code extension of the substituted official or agency.

Child 1 Last Name

20

1409–1428

A/N

Required.

Child 1’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 1 First Name

15

1429–1443

A/N

Required.

Child 1’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 1 Middle Name or Initial

15

1444–1458

A/N

Optional.

Child 1’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 1 Suffix Text

4

1459–1462

A/N

Optional.

Child 1’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 1 Gender

1

1463–1463

A

Required.

The gender of child 1.

Valid values:

F – Female

M – Male

U – Unknown

Child 1 Date of Birth

8

1464–1471

N

Required.

Child 1’s date of birth (DOB) in CCYYMMDD format.

Fill with spaces.

Child 1 SSN

9

1472–1480

N

Required.

Child 1’s SSN.

Child 2 Last Name

20

1481–1500

A/N

Optional.

Child 2’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 2 First Name

15

1501–1515

A/N

Conditionally required; must be filled if child 2’s last name is provided.

Child 2’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 2 Middle Name or Initial

15

1516–1530

A/N

Optional.

Child 2’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 2 Suffix Text

4

1531–1534

A/N

Optional.

Child 2’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 2 Gender

1

1535–1535

A

Conditionally required; must be filled if child 2’s last name is provided.

The gender of child 2.

Valid values:

F – Female

M – Male

U – Unknown

Child 2 Date of Birth

8

1536–1543

N

Conditionally required; must be filled if child 2’s last name is provided.

Child 2’s DOB in CCYYMMDD format.

Fill with spaces.

Child 2 SSN

9

1544–1552

N

Conditionally required; must be filled if child 2’s last name is provided.

Child 2’s SSN.

Child 3 Last Name

20

1553–1572

A/N

Optional.

Child 3’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 3 First Name

15

1573–1587

A/N

Conditionally required; must be filled if child 3’s last name is provided.

Child 3’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 3 Middle Name or Initial

15

1588–1602

A/N

Optional.

Child 3’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 3 Suffix Text

4

1603–1606

A/N

Optional.

Child 3’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 3 Gender

1

1607–1607

A

Conditionally required; must be filled if child 3’s last name is provided.

The gender of child 3.

Valid values:

F – Female

M – Male

U – Unknown

Child 3 Date of Birth

8

1608–1615

N

Conditionally required; must be filled if child 3’s last name is provided.

Child 3’s DOB in CCYYMMDD format.

Fill with spaces.

Child 3 SSN

9

1616–1624

N

Conditionally required; must be filled if child 3’s last name is provided.

Child 3’s SSN.

Child 4 Last Name

20

1625–1644

A/N

Optional.

Child 4’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 4 First Name

15

1645–1659

A/N

Conditionally required; must be filled if child 4’s last name is provided.

Child 4’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 4 Middle Name or Initial

15

1660–1674

A/N

Optional.

Child 4’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 4 Suffix Text

4

1675–1678

A/N

Optional.

Child 4’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 4 Gender

1

1679–1679

A

Conditionally required; must be filled if child 4’s last name is provided.

The gender of child 4.

Valid values are:

F – Female

M – Male

U – Unknown

Child 4 Date of Birth

8

1680–1687

N

Conditionally required; must be filled if child 4’s last name is provided.

Child 4’s DOB in CCYYMMDD format.

Fill with spaces.

Child 4 SSN

9

1688–1696

N

Conditionally required; must be filled if child 4’s last name is provided.

Child 4’s SSN.

Child 5 Last Name

20

1697–1716

A/N

Optional.

Child 5’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 5 First Name

15

1717–1731

A/N

Conditionally required; must be filled if child 5’s last name is provided.

Child 5’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 5 Middle Name or Initial

15

1732–1746

A/N

Optional.

Child 5’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 5 Suffix Text

4

1747–1750

A/N

Optional.

Child 5’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 5 Gender

1

1751–1751

A

Conditionally required; must be filled if child 5’s last name is provided.

The gender of child 5.

Valid values are:

F – Female

M – Male

U – Unknown

Child 5 Date of Birth

8

1752–1759

N

Conditionally required; must be filled if child 5’s last name is provided.

Child 5’s DOB in CCYYMMDD format.

Fill with spaces.

Child 5 SSN

9

1760–1768

N

Conditionally required; must be filled if child 5’s last name is provided.

Child 5’s SSN.

Child 6 Last Name

20

1769–1788

A/N

Optional.

Child 6’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 6 First Name

15

1789–1803

A/N

Conditionally required; must be filled if child 6’s last name is provided.

Child 6’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 6 Middle Name or Initial

15

1804–1818

A/N

Optional.

Child 6’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 6 Suffix Text

4

1819–1822

A/N

Optional.

Child 6’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 6 Gender

1

1823–1823

A

Conditionally required; must be filled if child 6’s last name is provided.

The gender of child 6.

Valid values:

F – Female

M – Male

U – Unknown

Child 6 Date of Birth

8

1824–1831

N

Conditionally required; must be filled if child 6’s last name is provided.

Child 6’s DOB in CCYYMMDD format.

Fill with spaces.

Child 6 SSN

9

1832–1840

N

Conditionally required; must be filled if child 6’s last name is provided.

Child 6’s SSN.

Child 7 Last Name

20

1841–1860

A/N

Optional.

Child 7’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 7 First Name

15

1861–1875

A/N

Conditionally required; must be filled if child 7’s last name is provided.

Child 7’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 7 Middle Name or Initial

15

1876–1890

A/N

Optional.

Child 7’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 7 Suffix Text

4

1891–1894

A/N

Optional.

Child 7’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 7 Gender

1

1895–1895

A

Conditionally required; must be filled if child 7’s last name is provided.

The gender of child 7.

Valid values:

F – Female

M – Male

U – Unknown

Child 7 Date of Birth

8

1896–1903

N

Conditionally required; must be filled if child 7’s last name is provided.

Child 7’s DOB in CCYYMMDD format.

Fill with spaces.

Child 7 SSN

9

1904–1912

N

Conditionally required; must be filled if child 7’s last name is provided.

Child 7’s SSN.

Child 8 Last Name

20

1913–1932

A/N

Optional.

Child 8’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 8 First Name

15

1933–1947

A/N

Conditionally required; must be filled if child 8’s last name is provided.

Child 8’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 8 Middle Name or Initial

15

1948–1962

A/N

Optional.

Child 8’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 8 Suffix Text

4

1963–1966

A/N

Optional.

Child 8’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 8 Gender

1

1967–1967

A

Conditionally required; must be filled if child 8’s last name is provided.

The gender of child 8.

Valid values:

F – Female

M – Male

U – Unknown

Child 8 Date of Birth

8

1968–1975

N

Conditionally required; must be filled if child 8’s last name is provided.

Child 8’s DOB in CCYYMMDD format.

Fill with spaces.

Child 8 SSN

9

1976–1984

N

Conditionally required; must be filled if child 8’s last name is provided.

Child 8’s SSN.

All Health Coverage Type Indicator

1

1985–1985

A

Conditionally required:

Either the All Health Coverage Available Indicator field or the Specific Health Coverage Indicator field and one of the specific health coverage indicators must be filled.

If the order type is TERM, this field is not required.

Indicates that all types of health coverage available are required.

Valid value: Y – All types of coverages needed.

Fill with spaces if a specific healthcare coverage type is required.

Specific Health Coverage Indicator

1

1986–1986

A

Conditionally required:

Either the All Health Coverage Available Indicator field or the Specific Health Coverage Indicator field and one of the specific health coverage indicators must be filled.

If the order type is TERM, this field is not required.

Specifies that specific health coverage is required.

Valid value: Y – Specific health coverage needed.

Fill with spaces if the All Health Coverage type is filled.

Medical Coverage Indicator

1

1987–1987

A

Conditionally required:

Either the All Health Coverage Available Indicator field or the Specific Health Coverage Indicator field and one of the specific health coverage indicators must be filled.

If the order type is TERM, this field is not required.

Specifies that medical health coverage is required.

Valid value: Y – Medical coverage needed.

Fill with spaces if the All Health Coverage type is filled.

Dental Coverage Indicator

1

1988–1988

A

Conditionally required:

Either the All Health Coverage Available Indicator field or the Specific Health Coverage Indicator field and one of the specific health coverage indicators must be filled.

If the order type is TERM, this field is not required.

Specifies that dental coverage is required.

Valid value: Y – Dental coverage needed.

Fill with spaces if the All Health Coverage type is filled.

Vision Coverage Indicator

1

1989–1989

A

Conditionally required:

Either the All Health Coverage Available Indicator field or the Specific Health Coverage Indicator field and one of the specific health coverage indicators must be filled.

If the order type is TERM, this field is not required.

Specifies that vision coverage is required.

Valid value: Y – Vision coverage needed.

Fill with spaces if All Health Coverage type is filled.

Prescription Drug Coverage Indicator

1

1990–1990

A

Conditionally required:

Either the All Health Coverage Available Indicator field or the Specific Health Coverage Indicator field and one of the specific health coverage indicators must be filled.

If the order type is TERM, this field is not required.

Specifies that prescription drug coverage is required.

Valid value: Y – Prescription drug coverage needed.

Fill with spaces if the All Health Coverage type is filled.

Mental Health Coverage Indicator

1

1991–1991

A

Conditionally required:

Either the All Health Coverage Available Indicator field or the Specific Health Coverage Indicator field and one of the specific health coverage indicators must be filled.

If the order type is TERM, this field is not required.

Specifies that mental health coverage is required.

Valid value: Y – Mental health coverage needed.

Fill with spaces if the All Health Coverage type is filled.

Other Health Coverage Indicator

1

1992–1992

A

Conditionally required:

Either the All Health Coverage Available Indicator field or the Specific Health Coverage Indicator field and one of the specific health coverage indicators must be filled.

If the order type is TERM, this field is not required.

Specifies that specific health coverage is required.

Valid value: Y – Other type of health coverage needed.

Fill with spaces if the All Health Coverage type is filled.

Other Coverage Type Description

60

1993–2052

A/N

Conditionally required:

Required if the Other Health Coverage Indicator field is filled.

If the order type is TERM, this field is not required.

Description of the type of coverage is needed.

Income Withholding CCPA Percent Rate

4

2053–2056

N

Required.

The highest percentage of income that can be withheld from the employee’s or obligor’s wages.

Two-digit decimal is assumed.

The field must be formatted as follows:

Numeric

Decimal assumed

Unsigned

Right-justified

Zero fill to left

Allowable Insurance Premium Amount

10

2057–2066

N

Optional.

The amounts allowed for health insurance premiums by the child support order.

Two-digit decimal is assumed.

Fill with zeros if not available.

The field must be formatted as follows:

Numeric

Decimal assumed

Unsigned

Right-justified

Zero fill to left

Zero fill if N/A

Effective Date of Medical Support Termination

8

2067–2074

N

Conditionally required; must be filled if the order type is TERM.

The effective date of medical support termination.

Must be in CCYYMMDD format..

Fill with spaces.

Reason for Termination

100

2075–2174

A/N

Conditionally required; must be filled if the order type is TERM.

Description of the reason the termination notice is being sent.

Child 1 Last Name to be Terminated Health Care Coverage

20

2175–2194

A/N

Conditionally required; must be filled if the order type is TERM.

Child 1’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 1 First Name to be Terminated Health Care Coverage

15

2195–2209

A/N

Conditionally required; must be filled if the Last Name of Child 1 to be Terminated Health Care Coverage field is filled.

Child 1’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 1 Middle Name or Initial to be Terminated Health Care Coverage

15

2210–2224

A/N

Optional.

Child 1’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 1 Suffix Name to be Terminated Health Care Coverage

4

2225–2228

A/N

Optional.

Child 1’s name suffix– for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 1 Date of Birth to be Terminated Health Care Coverage

8

2229–2236

N

Conditionally required; must be filled if the Last Name of Child 1 to be Terminated Health Care Coverage field is filled.

Child 1’s DOB in CCYYMMDD format.

Child 2 Last Name to be Terminated Health Care Coverage

20

2237–2256

A/N

Optional.

Child 2’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 2 First Name to be Terminated Health Care Coverage

15

2257–2271

A/N

Conditionally required; must be filled if the Last Name of Child 2 to be Terminated Health Care Coverage field is filled.

Child 2’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 2 Middle Name or Initial to be Terminated Health Care Coverage

15

2272–2286

A/N

Optional.

Child 2’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 2 Suffix Name to be Terminated Health Care Coverage

4

2287–2290

A/N

Optional.

Child 2’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 2 Date of Birth to be Terminated Health Care Coverage

8

2291–2298

N

Conditionally required; must be filled if the Child 2 Last Name to be Terminated Health Care Coverage field is filled.

Child 2’s DOB in CCYYMMDD format.

Child 3 Last Name to be Terminated Health Care Coverage

20

2299–2318

A/N

Optional.

Child 3’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 3 First Name to be Terminated Health Care Coverage

15

2319–2333

A/N

Conditionally required; must be filled if the Last Name of Child 3 to be Terminated Health Care Coverage field is filled.

Child 3’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 3 Middle Name or Initial to be Terminated Health Care Coverage

15

2334–2348

A/N

Optional.

Child 3’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 3 Suffix Name to be Terminated Health Care Coverage

4

2349–2352

A/N

Optional.

Child 3’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 3 Date of Birth to be Terminated Health Care Coverage

8

2353–2360

N

Conditionally required; must be filled if the Last Name of Child 3 to be Terminated Health Care Coverage field is filled.

Child 3’s DOB in CCYYMMDD format.

Child 4 Last Name to be Terminated Health Care Coverage

20

2361–2380

A/N

Optional.

Child 4’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 4 First Name to be Terminated Health Care Coverage

15

2381–2395

A/N

Conditionally required; must be filled if the Last Name of Child 4 to be Terminated Health Care Coverage field is filled.

Child 4’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 4 Middle Name or Initial to be Terminated Health Care Coverage

15

2396–2410

A/N

Optional.

Child 4’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 4 Suffix Name to be Terminated Health Care Coverage

4

2411–2414

A/N

Optional.

Child 4’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 4 Date of Birth to be Terminated Health Care Coverage

8

2415–2422

N

Conditionally required; must be filled if the Last Name of Child 4 to be Terminated Health Care Coverage field is filled.

Child 4’s DOB in CCYYMMDD format.

Child 5 Last Name to be Terminated Health Care Coverage

20

2423–2442

A/N

Optional.

Child 5’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 5 First Name to be Terminated Health Care Coverage

15

2443–2457

A/N

Conditionally required; must be filled if the Last Name of Child 5 to be Terminated Health Care Coverage field is filled.

Child 5’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 5 Middle Name or Initial to be Terminated Health Care Coverage

15

2458–2472

A/N

Optional.

Child 5’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 5 Suffix Name to be Terminated Health Care Coverage

4

2473–2476

A/N

Optional.

Child 5’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 5 Date of Birth to be Terminated Health Care Coverage

8

2477–2484

N

Conditionally required; must be filled if the Last Name of Child 5 to be Terminated Health Care Coverage field is filled.

Child 5’s DOB in CCYYMMDD format.

Child 6 Last Name to be Terminated Health Care Coverage

20

2485–2504

A/N

Optional.

Child 6’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 6 First Name to be Terminated Health Care Coverage

15

2505–2519

A/N

Conditionally required; must be filled if the Last Name of Child 6 to be Terminated Health Care Coverage field is filled.

Child 6’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 6 Middle Name or Initial to be Terminated Health Care Coverage

15

2520–2534

A/N

Optional.

Child 6’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 6 Suffix Name to be Terminated Health Care Coverage

4

2535–2538

A/N

Optional.

Child 6’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 6 Date of Birth to be Terminated Health Care Coverage

8

2539–2546

N

Conditionally required; must be filled if the Last Name of Child 6 to be Terminated Health Care Coverage field is filled.

Child 6’s DOB in CCYYMMDD format.

Child 7 Last Name to be Terminated Health Care Coverage

20

2547–2566

A/N

Optional.

Child 7’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 7 First Name to be Terminated Health Care Coverage

15

2567–2581

A/N

Conditionally required; must be filled if the Last Name of Child 7 to be Terminated Health Care Coverage field is filled.

Child 7’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 7 Middle Name or Initial to be Terminated Health Care Coverage

15

2582–2596

A/N

Optional.

Child 7’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 7 Suffix Name to be Terminated Health Care Coverage

4

2597–2600

A/N

Optional.

Child 7’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 7 Date of Birth to be Terminated Health Care Coverage

8

2601–2608

N

Conditionally required; must be filled if the Last Name of Child 7 to be Terminated Health Care Coverage field is filled.

Child 3’s DOB in CCYYMMDD format.

Child 8 Last Name to be Terminated Health Care Coverage

20

2609–2628

A/N

Optional.

Child 8’s last name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 8 First Name to be Terminated Health Care Coverage

15

2629–2643

A/N

Conditionally required; must be filled if the Last Name of Child 8 to be Terminated Health Care Coverage field is filled.

Child 8’s first name.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

Spaces

The first character cannot be a space.

Child 8 Middle Name or Initial to be Terminated Health Care Coverage

15

2644–2658

A/N

Optional.

Child 8’s middle name or initial.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space if the middle name is populated.

Fill with spaces if no middle name is available.

Child 8 Suffix Name to be Terminated Health Care Coverage

4

2659–2662

A/N

Optional.

Child 8’s name suffix – for example, Jr., Sr., or III.

Valid special characters:

Hyphens (-)

Apostrophes (’)

Periods (.)

The first character cannot be a space.

Fill with spaces if no name suffix is available.

Child 8 Date of Birth to be Terminated Health Care Coverage

8

2663–2670

N

Conditionally required; must be filled if the Last Name of Child 8 to be Terminated Health Care Coverage field is filled.

Child 3’s DOB in CCYYMMDD format.

Filler

100

2671–2770

A/N

This is for future versions. For this version, fill with-spaces.

Chart C‑3 contains the e‑NMSN Request Trailer Record layout.

Chart C‑3: e-NMSN Request Trailer Record Layout

Field Name

Length

Location

A/N

Comments

Record Identifier

4

1–4

A

Required.

The letters ENRT, which identify the record as a Request Trailer.

Employer FEIN

9

5–13

N

Required.

Employer FEIN.

Third-party FEIN

9

14–22

N

Optional.

FEIN of the third-party provider that will respond on behalf of the employer.

Fill with spaces if the state does not know the FEIN of the third-party provider.

FIPS Code

2

23–24

N

Required.

The two-digit locator code of the requesting state.

Record Count

6

25–30

N

Required.

The total number of records submitted in this batch.

The field must be formatted as follows:

Numeric

Unsigned

Right-justified

Zero fill to left

Zero fill if N/A

Portal Error Message Text

29

31–59

A/N

For Portal use.

Generated when the Portal performed its validation and found errors. Trailer records with errors return the entire batch. The returned batch contains all the requests originally sent.

Valid values:

BTCR – Invalid data in a conditionally required field

BTRF – Required field validation error

Each code is separated by a comma.

Left-justified and padded with spaces to the right.

Filler

2711

60–2770

A/N

This is for future versions. For this version, fill with spaces.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File Titlee-NMSM Software Interface Specification - Appendix C
AuthorOCSS Contractor
File Modified0000-00-00
File Created2024-09-16

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