Requirements for Enrollment

New employees must enroll or waive coverage through the Statewide Employee Benefit Enrollment System (SEBES) within 31 days of employment.

• If enrolling dependent(s), proof of eligibility must be sent to MCHCP following enrollment. Enrollment on dependent(s) is not complete until proof of eligibility is received by MCHCP. After receiving proof, effective dates of coverage are the same for you and your dependent(s).

A Change/Cancellation (M-2) form is required for:

• Enrollment of yourself and/or your dependents due to a life event.
  • If adding dependent coverage or enrolling dependent(s) when first eligible (within 31 days of the event), the form should be accompanied by proof of eligibility. 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 delay in applying for coverage. If you don’t have the birth certificate or SSN, make certain application is made by the 31 day deadline as it is strictly enforced.
• Changes to your coverage due to the following events:
  • Loss of Eligibility or Medicaid Status.
  • Military Leave.
  • Return to employment following Military Leave, Leave of Absence, or Leave of Absence due to Workers’ Compensation or Family Medical Leave.
  • Termination of coverage.
  • Transfer of employment to another State agency covered under MCHCP.

Coverage Levels

There are four levels of coverage:

1. Subscriber Only
2. Subscriber/Spouse
3. Subscriber/Child(ren)
4. Subscriber/Family