Did you have new dependent(s)?
Birth, Adoption, Placement for Adoption or Legal Guardianship
Employees have 60 days from the birth, adoption or placement for adoption/legal guardianship to report the event to the Employee Benefits Office in order to enroll newly eligible dependents. New dependent(s) will be added retro-active to the date of eligibility (birth/adoption/placement date). Newborn infants are automatically covered for the first 31 days on the mother's health insurance without enrollment paperwork, however, to continue the coverage, a change form needs to be submitted to the Employee Benefits Office.
This life event allows an employee to not only add new dependent(s), but also to add spouse/domestic partner or change health plan carriers.
The documents below are required to add new dependents* to health plan coverage and/or change plan elections.
- Bargaining Unit specific Medical and Dental election change form available by selecting bargaining unit affiliation at: Medical and Dental forms
- Marriage/Domestic Partnership Affidavit - Required to add a Spouse/DP to any benefit plans
*If adoption or legal guardianship, include copies of the court papers placing the child.
Marriage or New Domestic Partnership
Employees have 60 days from the date of marriage, registration (State or County) of domestic partnership or satisfying the 6 month waiting period of shared residency to report the event to the Employee Benefits Office in order to enroll newly eligible dependents. Eligible dependents include the new spouse/partner and children of the spouse/partner who meet child eligibility requirements under County Health Plans.
This life change allows an employee to not only add new dependents, but also to change health plan carriers or opt out of coverage* if new coverage is provided by spouse/partner.
The documents below are required to add new dependents to health plan coverage and/or change plan elections.
- Medical and Dental forms
- Marriage/Domestic Partnership Affidavit webform - Required to add a Spouse/DP to any benefit plans
- Opt-Out Affidavit webform - required if opting out of County medical coverage,
**Spouse/DP Supplemental Life Insurance Application - A new spouse/partner is eligible for guaranteed coverage up to $50,000 if requested within 30 days of the qualifying event.
All changes will be effective the first of the month following receipt of completed paperwork.