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Q&A: An employee who opted not to be on our medical plan is about to have a baby. Would this event allow the employee and their newborn child to enroll in our plan?

It would, yes. The birth of a child is a HIPAA special enrollment right, meaning the employee, their spouse, and their newborn child may enroll into the medical plan midyear.

However, it’s a somewhat common misconception to assume the employee can also enroll their other children, if they have any, at the same time. While it might be possible, depending on the provisions of your plan, we recommend checking your plan materials to be certain. Documents to double check include your cafeteria plan, if you have one, and your medical summary plan description.

Answer from Bethany, SPHR, SHRM-SCP:
Bethany is a seasoned professional with 20 years of business experience focusing on human resources and benefits for private and publicly traded companies in the technology, healthcare, manufacturing and service industries. She has led teams and supported transformations for companies of various sizes in domestic and global markets and understands how to approach the different complexities found in businesses with little to no HR framework and those at more advanced stages of HR development. In her spare time she’s an avid baker and enjoys spending time outdoors with her husband and dogs.

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