A newborn can be added the first of the month in which the baby is born or the first of the month following the birth. The Plan regularly receives requests to retroactively change the newborn's effective date to the first of the month in which the newborn was born. The majority of these requests are the result of members selecting the incorrect effective date in eBN because they do not understand that in order for the newborn to be covered from the date of birth, the coverage effective date must be the first of the month in which the child is born. For example, if a child is born November 20, 2011, the effective date would need to be November 1, 2011, in order for the child to be covered as of the date of birth.
  

Employees also do not realize that if they choose to cover their newborn the first of the month following delivery, they are responsible for any claims incurred in the birth month by the newborn if the newborn is not a well baby or after the initial 48 or 96 hours.
  

To alleviate this confusion and to avoid employees retroactively changing the newborn's effective date of coverage, which results in a double deduction of dependent premium and reprocessing of claims, the State Health Plan has modified the Benefitfocus system to only allow members to enroll newborns the first of the month in which the baby is born. If members would like to add a newborn the first of the month following the date of birth they must request that coverage effective date from their HBR. An exception form will have to be completed by the HBR and follow the exceptions process, which was explained in last month's HBR Update. 
 

Please make your employees in this situation aware of this new policy. For additional information on newborn health care coverage, please direct employees to the Family Planning section in their Benefits Booklet.