Adoption/Placement for Adoption/Guardianship of A Dependent Child

By adopting or taking guardianship of a dependent child, you become the primary person responsible for the child's needs and progress in life. The planning and care begin as soon as you start the adoption/guardianship process. The following information will help you navigate through the requirements of the Health Fund and the Pension Plan.

Forms:

• Health Fund Coordination of Benefits Form

• Health Fund Designation of Beneficiary for Life Insurance Form

• Health Fund Dependent Enrollment Form

• Pension Plan Designation of Beneficiary Form

Additional Information:

Health BenefitTabs™

• Eligibility

• Dependent Premium

• Life Insurance

Benefit Plan Checklist
	The first step is to decide whether you want to add your new child as a dependent on your health coverage. Under the Health Fund, dependent coverage requires a quarterly Dependent Premium of $150. Please keep in mind that the dependent premium includes all dependents you have added to your coverage. If you already have existing dependents, there is no additional premium due.
	To add your new dependent child, please complete a new Enrollment Form with the Health Fund. Be sure to attach a copy of the legal adoption, foster or guardianship papers. Please note: You must notify the fund of the adoption, placement for adoption, fostership or guardianship within 30 days or your request may be delayed until the following Open Enrollment period for an effective date of January 1, unless there is a "Special Enrollment" circumstance. In the interim, you may provide us with any temporary documents you may have from the appropriate agency or court. If this is your first dependent, please submit your Dependent Premium payment. Please be advised that coverage for your dependent child will be effective on the date of placement for adoption or in the case or guardianship or fostership, the date the guardianship or foster placement became effective. The Health Fund may also require proof that you provide the child's support. No benefits will be paid until required documents have been received.
	You may want to review your beneficiary designation with the Health Fund and the Pension Plan and make any changes you deem appropriate. If you would like to change your beneficiary designation for your life insurance, you must complete a Health Fund Life Insurance Beneficiary Card. If you would like to change your beneficiary designation for the Pre-Retirement Death Benefit under the Pension Plan, please complete a Pension Plan Designation of Beneficiary Form. Changing your beneficiary for the Health Fund does not change your beneficiary for the Pension Plan and vice versa. Please see Forms referenced on this page.