93 Special Enrollment is available for eligible individuals who: • Lost eligibility under a prior health plan for reasons other than non-payment of fees or due to fraud or intentional misrepresentation of a material fact. • Exhausted COBRA benefits or stopped receiving group contributions toward the cost of the prior health plan. • Lost employer contributions towards the cost of the other coverage; • Are now eligible for coverage due to marriage, birth, adoption, or placement for adoption. Important Notes about Special Enrollment: • Members who enroll during Special Enrollment are not considered Late Enrollees. • Individuals must request coverage within 31 days of a qualifying event (i.e., marriage, exhaustion of COBRA, etc.). Medicaid and Children’s Health Insurance Program Special Enrollment Eligible Subscribers and Dependents may also enroll under two additional circumstances: • The Subscriber’s or Dependent’s Medicaid or Children’s Health Insurance Program (CHIP) coverage is terminated as a result of loss of eligibility; or • The Subscriber or Dependent becomes eligible for a subsidy (state premium assistance program). The Subscriber or Dependent must request Special Enrollment within 60 days of the above events. Late Enrollees If the Subscriber does not enroll themselves and/or their Dependents when first eligible or during a Special Enrollment period, will not be eligible to enroll until the next Open Enrollment Period. Members Covered Under the Employer’s Prior Plan Members who were previously enrolled under another plan offered by the Employer that is being replaced by this Plan are eligible for coverage on the Effective Date of this coverage. Enrolling Dependent Children Newborn Children Newborn children are covered automatically from the moment of birth for a period of 31 days. To continue coverage beyond the 31 day period you should submit an application / change form to the Employer, within 31 days following the birth, to add the newborn to your Plan. Even if no additional fee is required, you should still submit an application / change form to the Employer to add the newborn to your Plan, to make sure the Claims Administrator has accurate records and are able to cover your claims. Newborn children coverage will be for injury or sickness, including: • The necessary care and treatment of medically diagnosed congenital defects and birth abnormalities; and