Dependent Child (to age 26) and Dependent Coordination of Benefits (COB)

Enroll/Drop my Dependent

If you want to enroll or drop a dependent child as a result of a qualifying event during the year, you must contact your organization's Human Resources/Benefits Office within 30 days of the qualifying event to request the coverage change.

If enrolling a dependent child for the first time, you MUST supply additional documentation to your organization’s Human Resources/Benefits Office within 30 days of the request, including birth certificate, social security card, adoption or other legal documents as applicable.

See Qualifying Events for more information, including a list of required supporting documentation .

Please be sure to review the information on the State’s Dependent COB Policy. You must complete a Dependent Child Coordination of Benefits (COB) Form ONLY if you are enrolling a new dependent(s) in your health coverage AND the dependent(s) have other health coverage. This policy does not impact the State’s dental and vision plan enrollment.