98 • 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 newbo rn to your Plan. Even if no additional Fees are required, you should still submit an application / change form to the Employer to add the newborn to your Plan, to make sure we have 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 • Medical and dental treatment (including orthodontic and oral surgery treatment) involved in the management of birth defects for cleft lip and cleft palate. Adopted Children A child will be considered adopted from the earlier of: (1) the moment of placement in your home; or (2) the date of an entry of an order granting custody of the child to you. The child will continue to be considered adopted unless the child is removed fr om your home prior to issuance of a legal decree of adoption. Your Dependent’s Effective Date will be the date of the adoption or placement for adoption if you send the Employer the completed application / change form within 31 days of the event. To continue coverage beyond the 31 day period you should submit an app lication / change form to the Employer, within 31 days following the adoption or placement for adoption.
2026 Anthem Certificate Plan A Page 98 Page 100