Please be sure to enter your Member ID WITHOUT
the NSA prefix—only the numbers, no letters.
- A completed New Dependent Form and a copy of the recorded birth certificate must be submitted to the Plan within 60 days in order to qualify for the special enrollment opportunity. You can also add dependents and submit a copy of the recorded birth certificate in your Benefits Manager.
- Note: The plan will accept a copy of the birth certificate from the hospital to add your biological child who is younger than one year of age for a period of up to 120 days while you obtain a recorded copy.