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We encourage you to speak to your employer regarding any specific membership requirements for eligible dependents.

Here are a few tips to keep in mind:

Newborn Child
You and your employer must submit a completed member application add/change form to Hometown Health within 30 days of birth to add your newborn child to your policy. Hometown Health will continue coverage for 31 days from birth. Please note: Hometown Health Plan does not send out notification of this process; it is your responsibility as a member to contact your employer to add your newborn to your policy within the 31 day period from the date of birth.

Adoption
You and your employer must submit a completed member application add/change form and a copy of the appropriate legal documentation to Hometown Health within 30 days of the event. If a child is adopted or placed for adoption, coverage will start on the date that the adoption becomes effective according to Nevada law or from the moment of placement in the member's home subject to certification of such placement by the placing agency.

Students 19 Years of Age and Older
For a full-time student to maintain coverage, Hometown Health Plan requires verification of full-time student status for dependent children who reach the dependent cut-off age. We require a letter from the accredited college or high school's Admissions and Records office, typically called a "Certificate of Enrollment," showing proof that the student is considered a full-time student. Please note that student class schedules are not accepted. Please contact your employer for more information on the dependent cut-off age limitations.

Dependents With Different Last Names
If you are adding a dependent with a last name that is different from that of the subscriber, you will be required to submit proof that your dependent is eligible as defined by Hometown Health Plan and your employer.

Add/Change Forms
You must present the add/change form to your employer for appropriate signatures. Hometown Health Plan must accept the form directly from the employer.

Medical Assessment Form
Medical Assessment Form If your employer has fewer than 51 employees enrolled with Hometown Health Plan, you may be required to complete a medical assessment form before coverage can take effect.

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