Adding New Dependents

Discover when you can add a spouse or dependent child to your coverage and what is required in each instance.

1. Adding a Spouse
   • Enrolling Before Date of Marriage
   • Enrolling After Date of Marriage
2. Adding Newborn Children
3. Adding Adopted Children
4. Applying for Coverage Prior to Birth or Adoption
5. Applying for Coverage After Birth or Adoption

Adding a Spouse

Enrolling Before Date of Marriage
If you marry after participation in the Plan and you want your spouse’s coverage to go into effect on the marriage date, you must enroll your prospective spouse prior to the date of marriage.

Example: Your wedding date is June 15 and you apply for coverage on June 7. Your spouse’s coverage would begin June 15. Note: You are responsible for premium payment for the entire month of June.

Enrolling After Date of Marriage
You may enroll your spouse within 31 days of the marriage. The appropriate premium is required for the month your spouse’s coverage goes into effect.

Example: Your wedding date is June 15 and you apply for coverage and submit a copy of your marriage license on June 20. Coverage will go into effect on July 1.

MCHCP must receive:

• Enrollment form within 31 days of the date of marriage, AND
• Proof of eligibility.

If proof of eligibility is not received, you will be unable to enroll your spouse until the next Open Enrollment for coverage to be effective the following January.

Adding Newborn Children

Coverage is provided for a newborn of a member from the moment of birth. However, appropriate forms must be completed and submitted for claims to be paid. Premium is not due for the first 31 days of coverage, however, premium will be due if coverage is to continue beyond the first 31 days.

To enroll a newborn or adopted child, notify MCHCP of the event, either orally or in writing, within 31 days of the date of birth. You are allowed an additional 10 days from the date the forms and instructions are provided to enroll the newborn child. Coverage will not continue past the first 31 days unless required documentation is received. If you have not yet received a Social Security number for the child, send the Change/Cancellation (M-2) form and birth certificate if you have it. DO NOT WAIT FOR A SOCIAL SECURITY NUMBER TO BE ASSIGNED. The 31 day enrollment period is strictly enforced. Advise MCHCP in writing of your new dependent’s Social Security number as soon as you receive it. Failure to provide proof of the dependent’s Social Security number in a timely manner may result in loss of coverage.

If your covered dependent has a child, the newborn must be added within 31 days of the birth for coverage. If you do not elect to enroll the newborn at the time of birth, you cannot enroll the child at a later date. Once your dependent loses coverage or is no longer eligible for coverage, his/her child is no longer eligible for coverage through MCHCP.

The date of birth starts day one in determining when the baby turns 32 days old.

Adding Adopted Children

When a child is placed for adoption, the child has the same eligibility requirements and procedures as a newborn.

Children who are adopted or placed for adoption are eligible for coverage on the date that child is placed for adoption. Apply for coverage within 31 days of placement for adoption.

There are no pre-existing condition limitations on newborns, adopted children, or children placed for adoption.

To enroll your new dependent child, you have the following options:

Applying for Coverage Prior to Birth or Adoption

Complete the Change/Cancellation (M-2) form and indicate the child’s expected date of birth or placement of child for adoption. Once the child is born or placed for adoption, complete a Change/Cancellation (M-2) form and provide proof of eligibility.

If you have child(ren) coverage, no additional premium is due.

If you do not have child(ren) coverage, the appropriate premium is required for the month in which the newborn turns 32 days old or 32 days from the placement of newborn adopted child(ren). For children adopted other than at birth, premium is due the month of placement.

Example: You apply for coverage for your child which is expected to be born mid-June. The baby is born on June 15. The baby is covered from the date of his/her birth. Premium is required for the month of July.

Applying for Coverage After Birth or Adoption

Coverage is effective on the day your child is born or placement of your adopted child. To enroll your child, submit the completed Change/Cancellation (M-2) form and proof of eligibility. The appropriate premium is required for the month in which your newborn turns 32 days old or 32 days from the placement of your adopted newborn child. For adopted children that are not newborns, premium is due the month of placement.