A: New dependents, including newborns, must be added to your benefits plan within 31 days of birth. Go to the ESS website at portal.houstontx.gov to add your newborn. Print and complete the fax cover letter and fax along with the Verification of Birth Facts or Birth Certificate to 832-395-9409, or email firstname.lastname@example.org. If you do not add your newborn in the time frame and provide the supporting document, you will have to wait until next year’s annual enrollment to enroll your child.
Q: I am an employee, and my wife has had end-stage renal disease (ESRD). What are her options for coverage? My co-worker also has ESRD, does he need to apply for Medicare?
A: Based on the type of treatment your spouse is receiving for her disease, she became eligible for Medicare up to three months after treatment began, if she applied for coverage. During the first 30 months she’s on Medicare, the city medical plan is the primary payer of her medical claims and Medicare is the secondary payer. At the end of 30 months, Cigna and Medicare will coordinate payment of medical expenses, with Medicare as the primary coverage and Cigna as the secondary coverage. If she does not enroll in Medicare, Cigna will pay as a secondary payer, and you will be responsible for the portion of her medical claims that Medicare should pay.
January through March is the annual enrollment for Medicare. Medicare then becomes effective July 1, unless she is given another effective date.
Your co-worker must also apply for Medicare and pay the monthly premium. Otherwise, at the end of 30 months, Cigna will pay his claims as a secondary payer and your co-worker will be responsible for the portion of medical claims that Medicare should pay.