Ohio Administrative Code
Title 5101:12 - Child Support
Chapter 5101:12-57 - Medical Support Provisions
Section 5101:12-57-99 - Chapter 5101:12-57 forms - enforcement of medical support provisions
Current through all regulations passed and filed through September 16, 2024
The forms identified in this rule are referenced within various rules contained within division 5101:12 of the Administrative Code. The effective or revised effective dates of the forms are as follows:
(A) JFS 03377, "Employer/Health Plan Administrator Health Insurance Verification Request" (rev. 1/2015);
(B) JFS 03399, "Notice of Administrative Mistake of Fact Hearing" (rev. 10/2019);
(C) JFS 04031, "Notice Regarding Cash Medical Support Order" (rev. 10/2019);
(D) JFS 04032, "Notice to Provide Cash Medical Support" (rev. 10/2019);
(E) JFS 04033, "Notice to Provide Private Health Insurance" (rev. 10/2019);
(F) JFS 04034, "Notice of Selection of Health Plan Option" (rev. 1/2015);
(G) JFS 04035, "Notice of Available Health Plan Options" (rev. 4/2022);
(H) JFS 04036, "Notice of Medical Support Enforcement Activity" (rev. 10/2019);
(I) JFS 04037, "Medical Support Enforcement Administrative Mistake of Fact Hearing Decision" (rev. 10/2019);
(J) JFS 04098, "Notice Regarding National Medical Support Notice Withholding Requirements" (rev. 1/2015);
(K) JFS 07053, "Notice of Medical Support Mistake of Fact Hearing" (rev. 3/2019);
(L) JFS 07058, "Medical Support Mistake of Fact Hearing Determination" (rev. 2/2019); and
(M) OMB 0970-0222, "National Medical Support
Notice" (NMSN) (
