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Enrolling an Adopted Child in Your Plan

If you have HMSA’s Plan for Federal Employees, please review Enrolling an adopted child for HMSA’s Plan for Federal Employees for more information.

Rules for enrolling an adopted child differ by plan type

Employer-sponsored group plans

To enroll an adopted child in your plan, you must notify your employer within 31 days of one of the following events:

  • The date of adoption,
  • The birth date of your adopted newborn, or
  • The date the child is placed with you for adoption.

If the request is made after 31 days, you will have to wait until your plan’s next open enrollment period; coverage for your child will be effective from the next enrollment effective date. The documentation you must submit to your employer may vary depending on your employer’s enrollment requirements.

If your documentation (e.g., baby’s birth certificate and adoption papers) is ready, you may pick the date of enrollment if more than one date could apply. For example, if you adopted your child on August 1 but your adopted child was born on July 3, you could choose to enroll your child within 31 days of their birth date and coverage starts on July 3. This can help ensure that your child is covered for health care expenses at the earliest date possible.

Employer-Union Trust Fund (EUTF) plans

If you’re an active EUTF employee, you must notify your department’s personnel officer and submit any required documentation to enroll an adopted child in your plan. If you’re a retired employee, please submit your request through the EUTF office.

Individual plans

If your individual plan allows coverage of dependents, an adopted child must be added to the plan within 31 days of the date of adoption, birth date of your adopted newborn, or date the child is placed with you for adoption. If the request is made after 31 days, you will have to wait until your next open enrollment period; coverage for your child will be effective from the next enrollment effective date.

If your documentation is ready (e.g., baby’s birth certificate and adoption papers), you may pick the date of enrollment if more than one date could apply. For example, if you adopted your child on August 1 but your adopted child was born on July 3, you could choose to enroll your child within 31 days of their birth date so that coverage starts on July 3. This can help ensure that your child is covered for any health care expenses at the earliest date possible.

Requests to enroll a child must be made in writing and sent to HMSA at the following address or fax number:

HMSA Membership Services Department
P.O. Box 860
Honolulu, HI 96808-0860

Fax: 808-948-6614 on Oahu

The request must include:

  • The child’s name.
  • The child’s date of birth, date of adoption, or date placed with you for adoption.
  • A copy of the certificate of live birth from the hospital or a birth certificate along with adoption documentation.
  • For individual HMO plans, please select an HMO health center and primary care provider (PCP) for the child and list the information in your request.

Determining the effective date of coverage for your adopted child

The effective date of coverage for your adopted child will depend on how the child is enrolled:

  • If you add your adopted child to your plan under the usual enrollment process within 31 days after the date of adoption, the date of adoption will be the child’s effective date.
  • Within 31 days after the child’s birth, if you send your employer a notice of your intent to adopt a newborn, the birth date of the newborn adopted child will be the child’s effective date.
  • Within 31 days after the placement, if you send your employer a notice that a child has been placed with you for adoption, the date the child was placed with you for adoption will be the child’s effective date. Placement occurs when you assume a legal obligation for total or partial support of a child in anticipation of adoption.