Employee status changes

Employee, spouse and newly acquired dependents may apply or Employee may add spouse and newly acquired dependents. Must receive application after the marriage date but within 31 days of marriage.

Effective date:

Date of Marriage

Forms needed:

Employee Application

Employee, spouse, qualified dependent and newborn may apply, or Employee may add spouse and/or newborn. Other dependents added at this time may be considered late enrollees. Premiums will be billed for coverage back to the newborn’s date of birth and interest may be applied.

Application to add a newborn should be received within 60 days of the birth, but will be accepted for up to 1 year from the newborn’s date of birth. Application to add other dependents must be received within 31 days of the birth. 

Effective date:

Date of Birth of Newborn

Forms needed:

Employee Application

Employee, spouse and new dependent may apply, or employee may add spouse and/or new dependent. Application to add adopted child must be received within 60 days of adoption or placement. Application to add other dependents must be received within 31 days of adoption or placement.

Effective date:

Date of Order for Legal Adoption or Placement

Forms needed:

Employee Application
Copy of Court Order Placing Child for Adoption

Employee may add legal ward. Employee needs to be covered under the plan at the time the legal ward is declared in order to enroll the appointed ward. Application must be received within 31 days from date of legal ward declaration.

Effective date:

Date of Legal Custody or Placement of Legal Ward

Forms needed:

Employee Application
Copy of Court Order Placing Child with Employee or Spouse
Verification of Residence and Percentage of Support

Spouse and dependent(s) may join the group plan. Application must be received within 31 days of transfer to the United States.

Effective date:

Date of Arrival in the USA

Forms needed:

Employee Application
Questionnaire & Copies of Visas are Required

If a person is absent from a job less than 31 days, they must report to the employer by no later than the beginning of the first full regularly scheduled work period on the first full calendar day following the completion of the active service.
 
If the active service lasted more than 31 days, but less than 181 days, the person must report to the employer no later than 14 days after the completion of the active service. If active service lasted for more than 181 days, but less than 5 years, the person must report to the employer no later than 90 days after the completion of the active service.

Effective date:

Eligibility will assign effective dates based on the dates requested by the group for those employees from military leave. If a group indicates an effective date equal to the date an Employee returned from the military, Dean Health Plan will honor that date.
 
If a group applies a probationary period for a returning employee, Dean Health Plan will honor that request as well.

Forms needed: