How Do I Declare a Spouse Loss of Coverage Event?
If your spouse has a loss coverage for any of the following reasons, you may enroll him/her in SHBP coverage:
* Spouse loss of eligibility for coverage through employer
* Spouse loss of eligibility for coverage due to employer’s open enrollment (note Plan year can be the same, but open enrollment dates must be different)
* Spouse loss of eligibility of coverage due to retirement
You must declare the event by notifying SHBP Member Services of your spouse’s loss of coverage by taking the following steps:
Within 31 days of your spouse’s loss of coverage...
Within 31 days of your spouse’s loss of coverage, you must declare the event by notifying SHBP Member Services 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
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 for Retirees: If you fail to timely notify SHBP Member Services, you will not have another opportunity to add your spouse, unless you experience another Qualifying Event or Special Enrollment Event to make a change to your coverage.
Within 45 days after you notify SHBP Member Services, you must provide the following:
- Letter from employer documenting name(s) of everyone who lost coverage, date of the loss of coverage, reason for the loss of coverage and/or discontinuation of coverage
- Copy of a certified marriage license or most recent jointly filed Federal Tax Return which includes legible signatures for both member and spouse
- Spouse’s Social Security Number (if your spouse does not have an SSN, please see information here)
- For children who loss coverage, a 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 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 within 2 to 4 business days 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 [email protected] or via phone at 800-610-1863 and select the appropriate prompt for Dependent Verification Services.