(1) If the CSSD determines that an obligor failed to provide or maintain health or medical insurance coverage pursuant to statute or court or administrative order, or if the obligor fails to provide information concerning such coverage, or both, the CSSD may cause to be served upon the obligor, a notice of such failure. The notice shall include:

(a) names of the obligor, the obligee and the child;

(b) a description of the court or administrative order, or statute which created the obligation to obtain and maintain insurance coverage;

(c) a statement of the monetary sanction to be assessed and the months for which the assessment is made;

(d) an order commanding the obligor to appear and show cause why the amount assessed should not become final;

(e) a statement that the amount finally assessed will be subject to income withholding, warrant for distraint and other remedies available to the CSSD to collect the assessed amount; and

(f) a statement of possible defenses to the assessment of monetary sanctions.