This guide to Qualified Medical Child Support Orders (QMCSOs) was created to provide a basic, but practical, summary of the major QMCSO rules as of September 1, 2021.

It provides information on:

  • QMCSO administrative requirements
  • QMCSO enrollment, disenrollment, and employee contribution requirements
  • Summary applicable requirements other than QMCSO rules
  • Sample procedures and documents

We also include a few general comments on consulting issues such as carrier rules or employer administrative concerns.

Private employers — both for profit and nonprofit — are required to comply with QMCSOs and National Medical Support Notices (NMSNs). Employers, including nonfederal governmental and church employers, are also required to comply with NMSN requirements. Requirements for QMCSOs and NMSNs are similar, but not identical. Both are discussed in this guide.

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Please note: This guide is intended to provide a basic, working knowledge of QMCSO rules. It is not an exhaustive discussion of all of the Department of Labor ("DOL") rules or nuances. It is intended to be a starting point; more detailed research may be required in specific areas.