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Special Enrollment Period as a result of gaining a new dependent An enrollee may enroll a new dependent for coverage if the new dependent was acquired as a result of any of the following qualifying events:

  • Marriage,

  • Birth,

  • Adoption, or placement in anticipation of adoption,

  • Legal custody,

  • Legal guardianship, or

  • Qualified Medical Child Support Order.

If an active employee is not covered by the Plan at the time of this qualifying event, he may enroll himself and any other eligible dependent(s).

To enroll for coverage under these circumstances, an Application for Coverage form must be submitted within 31 days of the event, and appropriate premium payments must be made. As part of the application process, the enrollee may be required to provide proof of the qualifying event. If these requirements are met, coverage under the Plan will take effect as of the date of the qualifying event. (In the case of a Qualified Medical Child Support Order, the coverage will be effective the 1st day of the month following the date of the order.) A copy of the procedures regarding QMCSOs can be obtained, without charge, by contacting the Department of Finance and Administration, Office of Insurance.

NOTE: If an enrollee is applying for coverage for a newborn, the Application for Coverage form must be submitted within 31 days of the child’s date of birth even if a Social Security number for the newborn is not available at the time. The Social Security number can be provided when received from the Social Security Administration.

Special Enrollment Period for a dependent returning to full-time student status An eligible dependent between the ages of 19 and 25 who is returning to school as a full-time student at an accredited high school, college, or university, may be enrolled for coverage under the Plan. The date of the qualifying event is the date the dependent returns to school.

An Application for Coverage form must be submitted within 31 days of the qualifying event, and the appropriate premium payments must be made. The effective date of the coverage will be the date of the qualifying event.

IMPORTANT NOTE If the enrollee does not apply for coverage for himself or his eligible dependents during any of the special enrollment periods described above, application cannot be made until an open enrollment period.

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