State Codes and Statutes

State Codes and Statutes

Statutes > North-carolina > Chapter_135 > GS_135-45_3

§ 135‑45.3.  Enrollment.

(a)        Except as otherwiserequired by applicable federal law, new employees must be given the opportunityto enroll or decline enrollment for themselves and their dependents within 30days from the date of employment or from first becoming eligible on anoncontributory basis. Coverage may become effective on the first day of themonth following date of entry on payroll or on the first day of the followingmonth. New employees not enrolling themselves and their dependents within 30 days,or not adding dependents when first eligible as provided herein may enroll onthe first day of any month but will be subject to a 12‑month waitingperiod for preexisting health conditions, except for employees who elect tochange their coverage in accordance with rules established by the ExecutiveAdministrator and Board of Trustees for optional or alternative plans availableunder the Plan. Children born to covered employees having coverage type (2) or(3), as outlined in G.S. 135‑45.4(d) shall be automatically covered atthe time of birth without any waiting period for preexisting health conditions.Children born to covered employees having coverage type (1) shall beautomatically covered at birth without any waiting period for preexistinghealth conditions so long as the claims processor receives notification within30 days of the date of birth that the employee desires to change from coverage(1) to coverage type (2) or (3), provided that the employee pays any additionalpremium required by the coverage type selected retroactive to the first day ofthe month in which the child was born.

(b)        Except as otherwiserequired by applicable federal law, newly acquired dependents (spouse/child)enrolled within 30 days of becoming an eligible dependent will not be subjectto the 12‑month waiting period for preexisting conditions. A dependentcan become qualified due to marriage, adoption, entering a foster childrelationship, due to the divorce of a dependent child or the death of thespouse of a dependent child, and at the beginning of each legislative session(applies only to enrolled legislators). Effective date for newly acquireddependents if application was made within the 30 days can be the first day ofthe following month. Effective date for an adopted child can be date ofadoption, or date of placement in the adoptive parents' home, or the first ofthe month following the date of adoption or placement. Firefighters, rescuesquad workers, and members of the National Guard, and their eligibledependents, are subject to the same terms and conditions as are new employeesand their dependents covered by this subdivision. Enrollments in thesecircumstances must occur within 30 days of eligibility to enroll.

(c)        When an eligible orenrolled member applies to enroll the member's eligible dependent child orspouse, the member shall provide the documentation required by the Plan toverify the dependent's eligibility for coverage.  (2008‑168, s. 3(g);2009‑16, ss. 3(c), 3(g); 2009‑281, s. 1.)