Policies for Newborn Coverage Updated

Adding a newborn to coverage:

• A member has 30 days from the date of birth to enroll the newborn in coverage.  Premiums must be paid for the full month of the child’s birth.
• Newborns can be added either the first of the month of the child’s birth or the first of the following month by filling out an Insurance Change Form.
• When a current employee or retired member requests coverage for a newborn grandchild, they must complete an Application for Coverage for Other Dependent Children.  Coverage for a grandchild can only be effective the first of the month following the receipt and approval of an application and payment of premium.  Coverage is not retro to the month of birth. After 30 days, the retired member cannot add the newborn to the coverage at any future time.
• Newborn coverage is subject to the annual deductible and plan limitations.  
• When one or more eligible dependents are currently covered, the newborn must be added to the same coverage.
• When a newborn is added to coverage, all other eligible dependents must be enrolled in coverage if they are not currently enrolled.  A member can waive health or dental coverage for their spouse.
• The newborn’s Social Security number is not required at the time of initial enrollment, but must be provided when it is received from the Social Security Administration.

Accepting the Newborn Benefit but NOT adding the newborn to coverage:

• There is no additional premium for the newborn benefit (See Plan Details.)
• The effective date of coverage is the child’s birth date.
• Enrollment of other eligible dependents is not required.
• Only applies if the mother or father of the newborn is covered.

Plan Details:

• • UnitedHealthcare - A newborn is covered for 31 days without an additional premium.  If the Plan member is the father, the Plan must be notified of the birth to receive the Newborn Benefit.
  • CommunityCare & GlobalHealth – A newborn is covered for 31 days without an additional premium.
  • HealthChoice Newborn Limited Benefit–
    • A newborn has limited coverage for a routine birth for the first 48 hours following a vaginal delivery or for the first 96 hours following a C-section delivery without an additional premium.
    • The member is responsible for any charges over and above the routine limited newborn benefit payment regardless of the facility’s Network or non-Network status.  A separate calendar year deductible and coinsurance is applied.
    • There are no benefits for services in addition to the routine hospital stay if the newborn is not enrolled and premiums paid for the month of the birth.

Declining the Newborn Benefit:
(Not recommended)

• A Newborn Benefit Waiver must be completed to exclude a newborn from the Newborn Benefit.