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Newborn Enrollment

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All newborn children must be enrolled as dependents within 60 days of birth in order to ensure coverage with no claims processing delays. 

Members with Individual, Employee/Spouse or Parent/Child contracts must submit an Enrollment/Change form to add a newborn, and change their plans to Parent/Child, Parent/Children or Family coverage (and pay the premium) within sixty (60) days after the date of the baby’s birth for coverage to be retroactive to the date of birth. Claims submitted before the newborn is enrolled under the correct contract type will be denied. These claims will be reprocessed once the newborn is enrolled, as long as it is within 60 days of the birth.

If Empire does not receive the Enrollment/Change form within 60 days after the baby’s birth, coverage will begin on the actual date we receive the completed form, as long as we receive it during the next open enrollment period after the birth, or during the first year after the birth, whichever occurs first.

If we do not receive the Enrollment/Change form after the next open enrollment period after the birth, or after the first year of birth (whichever occurs first), coverage is not available until the next open enrollment period.


Members with Family or Parent/Children contracts have coverage for newborn children but MUST submit an Enrollment/Change form to add the newborn to the benefit contract. Coverage is effective from the newborn’s date of birth provided that the newborn is enrolled.

 
For Enrollment through Employer Online Services: 
When the contract types are Individual, Employee\Spouse or Parent\Child and the Group Benefits Administrator (GBA) logs on to add the newborn after 60 days from the date of birth, the GBA may select either the current date (at which the GBA logged on) or the date of Open Enrollment as the effective date of coverage for the newborn. 
 
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