A dependent(s) may be added to an existing policy durring:
Note: Some small groups do not have open enrollments because of state laws forbidding them. Members of these groups may add eligible members at any time.
|Required Documentation||Effective date||Note|
|Group Enrollment Form||1st of the month following BCBSVT's receipt of form||Form must be signed and dated by EMPLOYEE|
|1st of the month following BCBSVT's receipt of the form and additional documenation||
Additional documenation requirements:
If any of these events listed below occur, you may request coverage for an eligible dependent.
|Event||Form Deadline||effective date||GBM
|New Hire/Rehire||No later than 60 days from date of eligibility||First of the month following date of receipt, but not prior to completion of probationary period.||pg. 13|
|Marriage/Civil Union||Within 31 days following marriage/civil union.||First of the month following marriage/civil union.||
|32 to 60 days following marriage/civil union.||First of the month following receipt.||pg. 22|
|Birth||Within 31 days following birth.||Date of birth for child and 32nd day after the birth for the membership type change.||
|32 to 60 days following birth.||First of the month following receipt.||pg. 23|
|Adoption||Within 31 days following adoption (or placement for adoption).||Date of adoption (or placement for adoption).||
|32 to 60 days following adoption (or placement for adoption).||First of the month after we receive the request.||pg. 24|
|Within 31 days after loss of coverage.
||Retroactive to date of coverage loss.||pg. 21|
|Within 90 days of the date of Medicare coverage||Date of Medicare entitlement. If received prior to Medicare effective date, coverage will be effective to coincide with Medicare.||pg. 33|
Employee who refused initial
|Prior to the Anniversary or Open Enrollment month.||First of the Anniversary or Open Enrollment month.||
|During the Anniversary or Open Enrollment month.||First of the month following receipt.||pg. 21|