Human Resources & Workforce Diversity
New Child in Family
You should know…
Your unmarried dependent children, stepchildren, and legal wards can be insured in the State Group Health Insurance plan. If you have family coverage in force when a new child enters your family, the child is covered automatically. If you have single coverage in force, you may switch to family coverage without restrictions by filing an application with your staff benefits office within 60 days of the birth or adoption (30 days if the child becomes eligible for any other reason). Coverage is effective on the date of birth or adoption.
Unmarried fathers with single coverage can change to family coverage within 60 days of the child’s birth, with family coverage effective on the date of birth. Paternity may be established at a later time due to a court order declaring paternity or a Voluntary Paternity Acknowledgement being filed with the Department of Health and Family Services (or the equivalent if outside of Wisconsin). In that situation, the child’s effective date is the date of the court order or the date the Voluntary Paternity Acknowledgement is filed.
The child of your unmarried dependent child under age 18 is also insured if you have family coverage. The grandchild’s coverage ends at the end of the month in which your child (the grandchild’s parent) turns age 18.
Other Enrollment Opportunities
If you fail to apply for family coverage when first eligible, you may switch from single to family coverage without restriction during the annual Dual Choice period. Family coverage then becomes effective January 1. Otherwise, you can obtain coverage at any time by filing an application, but you will be restricted to the Standard Plan with a 180-day waiting period. The Standard Plan is substantially more expensive than other health insurance plans.
What to do. . .
If you already have family coverage in place, to avoid delays in claims payment you should give notice of the new child by filing an application with your staff benefits office within 60 days of the birth or adoption. To switch from single to family coverage, you must file an application with your staff benefits office within 60 days of the birth or adoption. For more information, see the Department of Employee Trust Funds' health insurance web site, including the “It’s Your Choice” book.
Employee Reimbursement Account (ERA)
You should know . . .
Adding a new dependent may qualify as a Change in Status event, allowing you to change your contributions for the Medical Expense Account, the Dependent Care Account, or both.
What to do. . .
Contact Bill Aye at Fringe Benefits Management (FBMC) 608-829-0435 to see whether the addition of the new child qualifies as a status change. If it does, you must file a Change in Status form with FBMC within 30 days after the event.
You should know…
Under the ICI program, a woman is considered to be disabled for 6 weeks following natural childbirth or 8 weeks following a caesarean. If you have ICI coverage and you have less sick leave than needed to cover six weeks of leave, you may have two to four weeks of benefits available.
What to do….
See form ET-5106 for information on initiating a claim.
Family and Medical Leave (FMLA)
You should know. . .
You have a right to take leave from your job to care for your newborn or newly adopted child. The amount of leave available and the timing of the leave are set by state and federal law. You may use vacation or, in some cases, sick leave to cover your absence, or you may take unpaid leave. The University continues to pay its share of your health insurance premium while you are on family medical leave.
What to do. . .
Contact your staff benefits office as soon as possible to discuss your options. If you are interested in temporarily reducing your work hours, you also need to make arrangements with your department chair or supervisor.
You should know. . .
If you are insured under the State Group Life Insurance plan, you can also insure your spouse and dependent children. Dependent children include your unmarried children (including legally adopted children, children in adoptive placement under §48.837(1), Wis. Stats., stepchildren and legal wards) who are dependent upon you for at least 50 percent of their support and maintenance. Coverage is effective on the fifteenth day after birth and can extend until age 19 (age 25 if a full-time student), or longer if the child is incapable of self-support due to a long-term mental or physical disability.
If you have Spouse and Dependent coverage in force when the new child enters your family, the child is covered automatically. Otherwise, if you have Basic coverage on yourself, you can apply for Spouse and Dependent coverage without evidence of insurability when you first have a family member (a spouse or a dependent child) to insure. The application must be filed within 30 days of the event. If you do not apply within this deadline, you may later apply by providing evidence of insurability for your spouse and all dependent children.
You may select one or two units of coverage. Each unit provides $10,000 of insurance on your spouse's life, and $5,000 in coverage for each dependent child. Effective January 1, 2004, each unit costs $2.00 per month.
Coverage is effective on the fifteenth day after birth and can extend until the child reaches age 25, if eligibility is met.
What to do. . .
If you already have Spouse and Dependent coverage in force, your new child is covered automatically.
Otherwise, compare this plan with the coverage available under the Individual and Family Life Insurance Program (see below). You may not need both plans. If you choose the State plan, apply for Spouse and Dependent coverage within 30 days of the date you first have a family member to insure, or ask your staff benefits office for advice on applying under evidence of insurability.
Individual and Family Life Insurance
You should know. . .
If you are insured under the Individual and Family Life Insurance Plan, you can also insure your spouse and dependent children. Each child is initially insured for $2,500 or $5,000, with optional annual increases of $2,500 for a total of $10,000. The premium for $10,000 in children's insurance is $1.20 per month regardless of the number of children.
You may add children's insurance by applying within 30 days of the date your first child is born or adopted. Otherwise, you may apply at any time by offering evidence of insurability.
Coverage is effective on the fifteenth day after birth if child coverage is already in force. To apply for child coverage for the first time, you have 30 days after the event to turn in an application to your staff benefits office. Coverage begins the first of the month following the receipt of the application, but not before the child is fifteen days old. Child coverage can extend until the child reaches age 25, if eligibility is met.
What to do. . .
Consider your life insurance needs and compare the coverages available under the Individual and Family Life Insurance Plan with the State Group Life Insurance plan (see above). You may not need both plans. If you select the Individual and Family Life Insurance Plan, apply for children's coverage within 30 days of the date you first have a dependent child to insure, or ask your staff benefits office for advice on applying under evidence of insurability.
Accidental Death and Dismemberment Insurance
You should know. . .
Accidental Death and Dismemberment coverage for your spouse and dependent children is available under the University's AD&D Plan. If you elect family coverage, benefits for your spouse and dependent children are equal to a percentage of the benefits you elect for yourself.
What to do. . .
You may enroll or disenroll in the AD&D plan at any time. See your staff benefits office.
Excess Major Medical and Epic Dental Insurance
You should know…
The new child is covered automatically for 60 days following the birth or adoption. If you already have family coverage in force, you do not need to take any action.
What to do…
If you have single coverage in force, you must submit an application to your staff benefits office to add the child and change to family coverage within 60 days in order to continue coverage beyond that time period. Your premium will increase due to the change to family coverage.
You should know…
The child is covered automatically if family coverage is already in force.
What to do…
The child may be added to individual coverage by submitting an application to your staff benefits office within 31 days of the birth or adoption.
Many employees who are represented by a union have access to dental insurance through their union. Contact your union for more information.
You should know. . .
When your family changes, you should review your beneficiary designations to be sure that they are still appropriate.
You should know. . .
It's never too early to put aside some savings for your child's education. Tax-favored savings plans ("529" plans) are available from EdVest and other states' providers.
Return to Life Events list.
This document was last revised on June 12, 2007
