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Frequently Asked Questions
1. Who is an eligible subscriber?
- Eligible subscribers must be citizens of the United States, permanent residents or non-immigrants whose authorization status permits employment.
2. When can I enroll in Genesee Area Healthcare Plan?
- If an employee does not enroll himself/herself or dependents when initially eligible, he or she will not have a second opportunity until Open Enrollment, July
- A new employee is eligible to enroll at the time of hire.
Newly Eligible Dependent(s)
The following events qualify a dependent for addition to the subscriber’s coverage:
- Marriage (the spouse and any stepchildren)
- Birth (the newborn)
- Adoption (the adoptive or proposed adoptive child)
- A Qualified Medical Child Support Order is issued.
3. I am going to adopt a child. How do I get him on my plan?
Subscribers must complete a Dependent Adoption Form. Completion of a Dependent/Adoption form must be received within 60 days of the following events to be effective on the requested date:
- Child(ren) adopted or pending adoption effective as of the date of birth or as of the date legal proceedings were started.
- Foster child (Welfare Department assigned under State law).
- Child for whom the subscriber is a legal guardian or has legal custody (court stamped documentation will be required).
- Any other child who lives in the household who is claimed as a dependent on the employee/subscriber’s current federal income tax return.
4. I have a disabled child. What are the guidelines to make sure he remains on my plan after age 19.
An adult child who is incapable of self-sustaining employment may be eligible to continue coverage beyond the age where coverage would otherwise terminate. One of the following conditions must cause the incapacity:
- Mental illness
- Developmental disability as defined in the NYS Mental Hygiene Law
- Physical handicap
- The child must also meet all of the following conditions:
- The condition occurred before the dependent reached the maximum age under the certificate
The child was covered at the time he or she would have otherwise reached the maximum age under the certificate:
- The condition continues to exist
- The child remains unmarried
- The child remains dependent upon the subscriber for support
- The application for coverage as a disabled dependent is also dependent upon the review by and approval of, the Medical Director at Excellus BCBS.
Documentation requirements include both of the following:
A completed Disabled Dependent Form must be completed and signed by both the subscriber and the medical doctor. This application must be received prior to the dependent age limitation.