All documentation must be submitted during the Open/Switch Enrollment window or within 31 days of your date of hire or Qualifying Event effective date.
NOTE: If you have previously provided documentation for a dependent, you do not need to submit it a second time. If you are not sure if you have submitted the paperwork before, you may resubmit or contact Erisa at 1-855-618-1800 to confirm.
Adding a Spouse
- Marriage Certificate (must be court-filed and show filing date/acceptance; Marriage Licenses are not acceptable)
- Common-law marriages are not recognized under New Mexico statute; however, common-law marriages from states which do recognize them will also be recognized for benefit eligibility purposes
Adding or Dropping Coverage Due to a Change in Other Coverage
- Documentation from the other provider clearly showing you and/or the dependent who is affected and whom you will be adding or dropping as the covered participant; must include the effective date in which your other coverage started or ended
- If the change is related to Medicaid please submit the full letter of notice from your Medicaid provider
Adding a Domestic Partner
- Signed and notarized Domestic Partnership form (Note: must be 12 or more months since any prior identified documented or recorded termination of DP or marriage)
Divorce or Separation
- A copy of the relevant pages showing the date of separation or divorce and the name of the ex-spouse; by Department of Labor rules this must be submitted within 30 days to your employer and administrator as the ex-spouse is eligible for COBRA
Adding a Dependent Child
- Birth Certificate
- Court Issued Guardianship/Kinship Papers
- Court Issued Custodial Papers (must not have expired)
- Adoption Papers
Dependent Turning 26
- Dependents turning 26 automatically drop at the end of the month in which their 26th birthday takes place and no documentation is required
Adding your Domestic Partner's Children
- Birth Certificate or similar court-issued paperwork as described above identifying your domestic partner as the parent or legal guardian
Adult Disabled Dependents
- To receive plan coverage an adult disabled dependent must have been on your coverage prior to turning 26; a copy of the disabled dependent certification form must be filled out and submitted for approval by your medical carrier, then turned into EASI Gov for processing (forms at: https://www.mybenefitsnm.com/benefits-info.html)
Adding a Newborn
- A newborn may be added within 31 days of Date of Birth; proof of birth from the Hospital may be submitted in place of a Birth Certificate, but the BC must be submitted within 90 days of the DOB
Fax: 505-244-6009
Email: SONM@easitpa.com