Newly Eligible Employees
Congratulations on becoming eligible for SHBP coverage! As a Newly Eligible Employee, you have the opportunity to enroll in health coverage within 31 days of the date you transition to a benefits eligible position. Below are a few common questions from Newly Eligible Employees.
Frequently Asked Questions
How Can I Find Out More About the Coverage Options and Benefits Offered by SHBP?
How Long Do I Have to Enroll in SHBP coverage?
Within 31 days of the date you transition to a benefits eligible position
How Do I Enroll in SHBP Coverage?
Within 31 days of the date you transition to a benefits eligible position, you must make your Newly Eligible Employee elections by:
- Visiting the SHBP Enrollment Portal 24 Hours a Day/7 Days Per Week (for instructions on registering or logging in the SHBP Enrollment Portal, click here), or
- Contacting SHBP Member Services at 800-610-1863, Monday – Friday 8:30 a.m. to 5:00 p.m. ET and Saturday 8:00 a.m. to 5:00 p.m. ET
Making your election with your employer or through any other process does not satisfy the requirement to make your election directly with SHBP via the SHBP Enrollment Portal or SHBP Member Services. If you fail to make your election via the two options provided above within 31 days of the date you transition to a benefits eligible position, you must wait until the next Open Enrollment period, unless you experience another Qualifying Event or Special Enrollment Event to enroll in health coverage.
When Will My Coverage Begin?
The effective date of coverage for Newly Eligible Employees is the first of the month following one full calendar month in a benefits eligible position with an SHBP Employing Entity (e.g., State Agencies and Public School Systems), unless the date you transition to a benefits eligible position is concurrent with the First Workday of the month. If the date you transition to a benefits eligible position is concurrent with the First Workday of the month, then coverage is effective the first day of the month following the date you transition to a benefits eligible position.
- If you transition to a benefits eligible position on January 31, 2020, one full calendar month following January is February 1, 2020 – February 29, 2020, and coverage would begin the first day of the month following February, which would be March 1, 2020
- If you transition to a benefits eligible position on April 1, 2020, since the date you transitioned to a benefits eligible position is concurrent with the first day of the month, coverage would begin the first day of the following month, which would be May 1, 2020
- If you transition to a benefits eligible position on October 15, 2020, one full calendar month following October is November 1, 2020 – November 30, 2020, and coverage would begin the first day of the month following November, which would be December 1, 2020.
When Will My Dependent’s Coverage Begin?
Generally, your dependents will be placed in a pending status (meaning SHBP will not cover them immediately) until: 1) the required dependent verification documentation is submitted within 45 days after you make your Newly Eligible Employee election proving your dependent is eligible for coverage, or 2) the deadline to provide the documentation has passed, whichever occurs first.
Is There Any Documentation Required If I Elect Coverage for My Spouse and/or Child?
Yes. Within 45 days after you make your Newly Eligible Employee election, you must provide verification documentation for all dependents you elected to enroll in health coverage, which generally includes the following.
- For a 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 Note on Social Security Numbers below)
- For a child: 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 Note on Social Security Numbers below)
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 within 1 to 2 business days 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 within 2 to 4 business days. This process is referred to as your DVS Audit and your dependent(s) 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.
If you need to speak with a member of the DVS team, please contact SHBP Member Services via email at [email protected] or via phone at 800-610-1863 and select the appropriate prompt for Dependent Verification Services.
Note on Social Security Numbers
SHBP requires a valid SSN for everyone enrolled in SHBP coverage. However, SSNs are not the only Taxpayer Identification Numbers (TIN) accepted by SHBP. For more information, please see the “Invalid/No Social Security Number (SSN) FAQs”.