Form 1 e-NMSN: Plan Administrator Profile

OMB 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)
Plan Administrator Profile Form, the organization agrees that:
The plan administrator, union, or third-party responder 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,
plan administrator, union, or third-party responder shall report confirmed or suspected incidents to
OCSE as specified in this paragraph. The requirement for the plan administrator, union, or third-party
responder 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 process and respond to NMSN notices received from an employer or
third-party provider 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/national-medicalsupport-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 responding to NMSNs electronically.
The organization’s representative completing this form is authorized to act on behalf of the plan
administrator, union, or third-party responder 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 sending e-NMSN responses.
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 eNMSNs.
Accept

Decline

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e-NMSN Plan Administrator 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.
Plan Administrators and Unions:
• Register as either a plan administrator or union using this form.
• Complete the e-NMSN FEINs Spreadsheet to identify each employer and, if applicable, their subsidiaries
for whom you will process and return Part-B responses.
• Receive Part-B forms from the employer.
• Provide Part-B responses on the Pick-Up server.

Third-party Responders (only responding to e-NSMNs on behalf of clients):
• Register as Third Party: Responder Only using this form.
• Use the e-NMSN FEINs Spreadsheet to identify each employer FEIN for whom you will provide e-NMSN
responses.
• Receive e-NMSNs from employers.
• 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.
• If you are receiving e-NMSN orders and using a union or labor organization 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.

Note: Third-party responders, plan administrators, or unions that want to receive e-NMSNs for their own
employees must register as an employer.

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General Information
Date:*
(The date you are completing the form using MM/DD/YYYY format.)

FEIN:*
(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.)

Organization Type: *

Select Third Party: Responder Only if you are responding to
Part-A and, when applicable, Part-B.
Select Union if you are a union acting as a plan administrator
and are responding to Part-B.)

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: *

State: *

ZIP Code Extension

ZIP Code:*
-

(Enter a five-digit ZIP code and the optional four-digit extension.)

Contact Information
Enter the organization’s business, technical support, and alternate contact information.
Note: At least one person must be designated to receive automated emails.

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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:

(Enter numeric characters
only. Include the area code.
Format: 1231231111)

Phone Ext:

(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)

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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 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)

Alternate Technical Contact Information
Enter additional technical contact information for 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:

(Enter numeric characters
only. Include the area code.
Format: 1231231111)

Phone Ext:

(Enter numeric characters
only. Include the area code.
Format: 1231231111)

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File Processing 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: *

Select Yes if you want OCSE to encrypt all files delivered to your server. OCSE
uses GPG for encryption.

Yes

No

If you select Yes, you must attach your company’s PGP or GPG encryption
key when returning this profile form.

Are your files stored behind your organization’s firewall?
Yes

No

This field is only required if you selected No in the Encrypt files option.

File Processing Information
How do you want to receive and respond to e-NMSNs? Note: If you are registering as a Third-Party Responder, you will only
respond to e-NMSNs.
No Programming
(PDF format)

Programming
(System-to-System)

No Programming and Programming Option information is listed
below.

No Programming File Information
• You will receive the NMSN and Part-B in PDF format from the employer. If you are a third-party responder, you may also
receive Part-A in PDF format from the employer.
• 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 (in the chart below) 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 is selected in the File Processing Information
section above.
Select e-NMSN/Part-A file format:
Flat file

XML

If you chose Third Party: Responder Only as your organization type,
select a Part-A Response File format. If you are a plan administrator or
a union, skip this question. Flat files have a .txt file extension.

Select Part-B Response File format: *
Flat file

XML

Flat files have a .txt file extension.

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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 PDF forms.

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. There can be multiple batches 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.

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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 one of 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
Outgoing Part-A Files

Standard/Organization-Supplied
File Naming Convention
OCSE Standard

If you are returning the Part-A
responses, this field is required.

File Naming
Convention
(Example: 123456789.
ARF.200708060115087.0000.txt)

Organization-Supplied
Outgoing Part-B Files *

OCSE Standard

(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

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Pick-Up Server Information
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:

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 Plan Administrators. 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.

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