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Add a newborn or adopted child

Find information for employees seeking to enroll eligible newborns or adopted children for coverage.

General information and requirements

Updated 3/2021

Applicable to

Employees covered by Public Employees Benefits Board (PEBB) benefits who are requesting to enroll eligible newborns or adopted children to their medical, dental, or life insurance coverage.

Relevant rule: WAC 182-12-(128), (262)

Newborn children may be enrolled in medical and dental coverage upon birth and adopted children may be enrolled when the employee assumes legal obligation for total or partial support in anticipation of adoption. If enrolling the newborn in medical and or dental coverage, the child's coverage will begin on the date of birth. If enrolling a newly adopted child, coverage will begin on the date of placement or the date a legal obligation is assumed in anticipation of adoption, whichever is earlier.
If the employee previously waived medical coverage, he/she must enroll in medical to add an eligible dependent to medical coverage. Coverage for the employee begins the first day of the month in which the event occurs.
To enroll a spouse or state registered domestic partner of an employee, coverage will begin the first day of the month in which the event occurs.

Additional information

Any changes must correspond to the special open enrollment event. To make a change to medical and dental or add a spouse or state-registered domestic partner, the employee must submit a completed Employee Enrollment/Change form no later than 60 days after the date of the qualifying event to their personnel/payroll/benefits office.
When a newborn or adopted child effective date is before the 16th day of the month, the employee will pay the full month's employee premium. Otherwise the new premium will begin with the next full calendar month.
Erin Act (RCW 48.43.115(3)(f)) : When the mother's medical plan has maternity benefits, a newborn child will receive 21 days of coverage under the plan automatically, regardless if the child is ultimately enrolled in the mother's plan or not.

Employee options

Employee may...	...within...	...or this will happen
Enroll the newborn or adopted child in medical and/or dental coverage.	If adding the child increases the employee premium: Employee Enrollment/Change form must be received no later than 60 days after the date of the birth, adoption, or the date the legal obligation is assumed for total or partial support in anticipation of adoption. If adding the child does not increase the employee premium: Employee Enrollment/Change form must be received as soon as possible to ensure timely payment of claims. If adding a state-registered domestic partner's child, the employee must also complete and submit the Declaration of Tax Status form if the child does not qualify as their tax dependent for federal tax purposes.	Employee must wait for annual open enrollment to enroll for the next year or have a qualifying special open enrollment event.
Enroll in Child Life optional life insurance (14 days old to age 26)	60 days of the birth, adoption, or the date legal obligation is assumed for total or partial support in anticipation of adoption.	Employee can apply for Child Life optional life insurance at any time, but statement of health will be required if enrolling more than 60 days after this special open enrollment event.
Change medical and/or dental plan, provided the employee enrolls the child.	60 days of the birth, adoption, or the date legal obligation is assumed for total or partial support in anticipation of adoption.	Employee must wait for annual open enrollment to change plans for the next year or have a qualifying special open enrollment event.
Add or change their Medical Flexible Spending Arrangement (FSA) or Dependent Care Assistance Program (DCAP).	60 days of the birth, adoption, or the date legal obligation is assumed for total or partial support in anticipation of adoption.	Employee must wait for annual open enrollment to enroll for the next year or have a qualifying special open enrollment event.

Employer requirements

Verify all forms submitted by the employee are correct and complete.
Determine if all dependents being added to the coverage are eligible (WAC 182-12-260).
Enroll coverage for child in the PAY1 insurance system effective the date of birth, date of adoption, or the date the employee assumed legal obligation for total or partial support in anticipation of adoption.