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Retiree - Add or Delete Dependents on Group Insurance

Retirees must complete the appropriate election form ("Retiree Health Insurance - Forms" link) to add or delete a dependent from a Montgomery County Group Insurance Plan due to a life event (also called a "qualified status change" or "qualifying event". See eligibility information and additional documentation required in the "Required Documentation and Dependent Eligibility" sheet under the "Changing Your Insurance" section ("Retiree Health Insurance - Materials" link).

Newborns are covered as of the date of birth, and the County will accept hospital discharge papers as supporting documentation for enrollment purposes. Birth Certificates and Social Security numbers are required and a copy must be sent to Office of Human Resources Health Insurance Team when received. For all dependent additions and deletions, retirees must complete the "Dependent Coverage section of the Health and Life Insurance Election Form ("Retiree Health Insurance - Forms" link).

Submit completed forms and required supporting documentation to Office of Human Resources, Health Insurance Team, 101 Monroe Street, 7th Floor, Rockville, MD 20850 or fax to 240.777.5131.

Find more information from the following link(s):
To speak with a Customer Service Representative, please call 311 during business hours.