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Good Morning,
I have a question about health insurance for an anticipated match/placement. We were recently matched with an expectant mother who is due on or around May 01, 2011. We are trying to get all of our ducks in a row and our insurance company/ HR department is not being very cooperative.
I have researched, and to my understanding the baby would have immediate health benefits through "the adoptive parents" as long as the temp. custody forms are complete, and the TPR is signed. Did I not understand this correctly? The HR dept. at our employer is firm in stating that the child would not be covered until the adoption is final. Many of you know finalization can take up to a year to complete! Our agency also stated that all "insurance" companies ever requested from them was a letter signed and dated along with a copy of the temp. custody paperwork/and an intent to adopt?
Any advise, references, experience or facts would be greatly appreciated. We would like to begin our search for a pediatrician in the next few weeks. Obviously I won't be able to find one without an answer to this question.
I would also like some information to approach the HR director (she was VERY RUDE TO US).
Thank you in advance for your help in this matter!
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The insurance carrier your work uses should have an informational guide that they give out during open enrollment--ask for that from your HR person. Ours listed events that made you eligible for a change in Plans outside of open enrollment-adoption being one. You can also ask him/her for the enrollment forms--for out insurance company, that is where it specifically listed what was needed as evidence to add a dependent.
Yes, a child can be added when he/she is PLACED for adoption-prior to finalization. Our adoption agency gave us a signed letter stating that, and specifically said "this is what your insurance company is going to want to see." the only hitch we experienced was the letter stated "Baby Boy Pitt" (not his real name!) and they wanted "Bradley John Pitt." the agency faxed us a new one. The insurance company added him and we just need to send his SS# after finalization.
Another thing, you'll want to know how long you have to get him/her on your insurance--we had 30 days. I'm not sure if that's standard or specific to our carrier.
Good luck!
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I'm copying this from a message I received answering this question:
The Omnibus Budget Reconciliation Act of 1993 (OBRA'93), Public Law 103-66, amended the Employee Retirement Income Security Act of 1974 (ERISA). The amended law requires that any group health plan which provides coverage for dependent children must provide benefits to a child placed for adoption under the same terms and conditions as apply to a child who is the biologic child of a plan participant. OBRA'93 specifically eliminated any requirement that the adoption be finalized in court before there is coverage. The new law also prohibits carriers from restricting coverage of adopted children on the basis of a preexisting condition. The changes implemented by OBRA'93 apply to the medical benefit plans of all employers subject to ERISA. Since ERISA covers almost all employers except government employers, OBRA'93 provided broad coverage to families with adopted children.
Basically, although your HR dept and the insurance company may tell you otherwise, insurance is required to cover an adopted newborn just as they would a baby born to you.
Hope this helps!
:hippie:
Hi,
If you're HR professional is being difficult, you can contact the insurance company directly. Sometimes the HR people just don't know all the ins and outs of the policy.
When we had to provide insurance information to our agency, I just looked at our policy myself, then called our the insurance company to confirm. I found that the insurance covered any dependent child in my home just like the OBRA'93 post states. The insurance company people are usually very helpful in explaining what is available.
Good luck!