Special Enrollment New Dependent

A retiree (or surviving spouse) may enroll a new dependent if the new dependent was acquired as a result of any of the following qualifying events:

To enroll the new dependent, an Application for Coverage form must be submitted to BCBSMS within 60 days of the date of the qualifying event and the appropriate premiums must be paid. Any Application for Coverage form received by BCBSMS more than 60 days from the date of the qualifying event will be returned, and coverage will not be available.

As part of the application process, proof of the qualifying event may be required. If these requirements are met, coverage under the Plan will take effect on the date of the qualifying event. In the case of a QMCSO, the coverage will be effective the first day of the month following the date of the Order.