How Do I Notify SHBP of Becoming Eligible for Premium Assistance?
If you are an Active Member with dependents not currently covered by SHBP that become eligible for Premium Assistance from Medicaid or SCHIP, you may enroll any eligible dependents in SHBP coverage, and change your Plan Option and/or Tier.
If you are an eligible employee not currently covered by SHBP with dependents that become eligible for Premium Assistance from Medicaid or SCHIP, you may enroll yourself and any eligible dependents in SHBP coverage.
Within 60 days of Becoming Eligible for Premium Assistance...
Within 60 days of becoming eligible for Premium Assistance, you must declare the event by contacting SHBP Member Services at 800-610-1863, Monday – Friday 8:30 a.m. to 5:00 p.m. ET. The Premium Assistance Letter verifies to SHBP that you are eligible to declare the Event. Therefore, SHBP Member Services will request a copy of your Premium Assistance Letter and provide submission instructions.
If you fail to timely notify SHBP Member Services, you must wait until the next Open Enrollment period, unless you experience another Qualifying Event or Special Enrollment Event to make a change to your coverage.
Note: if you have a Newborn (i.e., child under the age of ninety (90) days old) that has been approved for Premium Assistance, you do not need to declare a Premium Assistance Event as your premiums with SHBP will not change the amount of the Premium owed to SHBP. The Premium Assistance is provided to you or your employer directly and not SHBP. Therefore, please click here to declare a Newborn Event if your child is under the age of ninety (90) days old, which will allow SHBP to add your newborn immediately.
Within 45 days after you notify SHBP Member Services...
Within 45 days after you notify SHBP Member Services, you must provide the following dependent verification documentation to add your spouse and/or child(ren):
- For your spouse: 1) copy of a certified marriage license or most recent jointly filed Federal Tax Return which includes legible signatures for both member and spouse and 2) spouse’s Social Security Number (if your spouse does not have an SSN, please see information here)
- For your child(ren): 1) copy of a certified birth certificate or birth card issued by the hospital listing parents by name and 2) child’s Social Security Number (if your child does not have an SSN, please see information here)
To assist you in providing the verification documentation...
To assist you in providing the verification documentation, our Dependent Verification Services (DVS) team will send you a letter with a unique bar code from SHBP via email if you have an email address on file; and if no email address is on file, the letter will be mailed to you if you have an address on file. This process is referred to as your DVS Audit and you and/or your dependent(s) as applicable, will not be enrolled in SHBP coverage until you provide the necessary verification documentation proving eligibility for coverage and the DVS team approves your Audit.
Please do not submit verification documentation until you receive your letter from DVS. Providing documentation to anyone, including your employer or other entity not appointed by SHBP for this purpose, or via any other means not provided for in this letter will result in you failing the DVS Audit. If you fail the DVS Audit, you must wait until the next Open Enrollment period, unless you experience another Qualifying Event or Special Enrollment Event to make a change to your coverage.
Need to Speak with Someone?
If you need to speak with a member of the DVS team, please contact SHBP Member Services via email at SHBPservicecenter@adp.com or via phone at 800-610-1863 and select the appropriate prompt for Dependent Verification Services. If you have already notified SHBP of your becoming eligible for Premium Assistance, you may visit the SHBP Enrollment Portal for updates 24 Hours a Day/7 Days Per Week (for instructions on registering or logging in the SHBP Enrollment Portal, click here).