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To add newly acquired dependents, including newborns, to state-sponsored insurance coverage, the employee must notify BA within 30-days of the acquire date. Documentation is required to add any dependent to coverage.
If Benefits Administration receives a completed enrollment change application and a copy of the newborn’s birth certificate before the enrollment deadline has expired, the newborn’s coverage will be retroactive to the date of birth. Any newborn claims that were previously filed and denied will then be reprocessed. Once the initial enrollment deadline has passed, eligible dependents may only be added if qualified through a special enrollment provision or during the plan's annual enrollment period.
Hospital staff may advise members that newborns are automatically added to coverage for the first 30 or 31 days of life based on state law. However, newborns are not automatically added to state-sponsored insurance plans under the State Group Insurance Program.
Grandchildren are not eligible for coverage in the State Group Insurance Program unless placed with a head of contract by a court of competent jurisdiction under a valid order of guardianship, custody, or conservatorship. Proof of documentation will be required.
State, Local Education and Local Government Plan Documents are the legal publications that define eligibility, enrollment, benefits and administrative rules of the State Group Insurance Program. The plan documents can be found under “Medical Plan Documents” at https://www.tn.gov/partnersforhealth/publications/publications.html. Plan Document Section 1.11 details eligible dependent categories. Section 2 details eligibility and enrollment requirements.
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