About Us Contact Us
Login to

New Child

What You Need to Know…

  • Unless you are covered under Certified Retiree or Retiree Carry-Over Coverage, you can add your natural born children, stepchildren, children over whom you retain legal guardianship and adopted children as dependents under your Health Plan until they turn age 26. (For information on adding stepchildren, go to Getting Married.)
  • You have 31 days from the date of birth/adoption to enroll your child under your Health Plan coverage. If you miss the 31-day deadline, you will not be able to add them until your next open enrollment period.
  • If you choose not to initially cover your child under your health coverage because he or she is covered under other health coverage, you will be able to add him or her to your coverage at the time the other coverage ends. You must notify the Health Plan within 60 days after the other coverage ends and you must provide a copy of your child’s Certificate of Coverage from the other health plan.
  • Children age 18 and over are considered adult dependents under the Health Plan, and their Health Plan mail (including Explanations of Benefits and other claims information) will be sent to them and any Health Plan-related checks made out to him or her unless he/she completes an Adult Dependent Authorization Form.

  • To enroll your child, you will need the following documentation:
    • A Dependent Enrollment Form. Complete and return this form along with a copy of your child’s certified birth certificate or a copy of the adoption or legal guardianship documents along with the applicable premium payment.
    • A copy of your child’s certified birth certificate, certificate of adoption or legal guardianship documents. If you do not have a certified birth certificate at the time, you can provide an uncertified copy as temporary documentation or alternate proof (such as a hospital birth announcement), but an official copy will be required within 6 months.
  • Adult Dependent Authorization Form. If your child is over age 18 and wishes for his/her Health Plan mail (including Explanations of Benefits and other claims information) sent to and checks made out to you (the primary participant), he/she must complete the Adult Dependent Authorization Form.

  • An additional premium is due on behalf of your dependents. The amount of the premium is based on the number of dependents that are enrolled under your coverage and the type of Health Plan coverage you have:
    • If you are on earned coverage, the dependent premium is as follows:
      • $390 semi-annually or $780 per year for one dependent
      • $600 semi-annually or $1,200 per year for two or more dependents

      The dependent premium will not be prorated for shorter periods of coverage.

    • If you are on COBRA or self-pay coverage, please refer to the premium schedule identified in your open enrollment letter or contact the Health Plan’s Eligibility Department at (877) 866-2200, Ext. 502.
  • The information on this page is only a summary of Health Plan rules. For detailed information, please refer to:

  • You may wish to list your child as a beneficiary (see below).
  •  
  •  
  •  
  •  
  •  

  • Beneficiary Designation Form – If you would like to add your child as a beneficiary, you must complete a new Beneficiary Designation Form. If you are married and would like your new child to be your primary beneficiary, you will need to obtain spousal consent.