D.C. Government Finally Explains How to Get Your Adopted Child Health Insurance
Last month, I wrote a story about Jenn Thomas and Kevin Fox, two local teachers who have spent three and a half years fighting with the D.C. government to get their adopted son, Max, added to their health insurance plan.
The parents, who are insured through Fox's D.C. Public Schools job, were repeatedly told by D.C. government reps that Max could not be added to the health insurance until they produced a Finalization of Adoption Decree from the courts—a document that wouldn't exist until Max was 18 months old, and the family had already racked up thousands of dollars in regular newborn medical fees. Thomas and Fox countered that federal laws required D.C. to insure Max from the day they became financially responsible—his date of birth. They argued back and forth like this for years: Date of finalization, date of birth, date of finalization, date of birth. The D.C. government wouldn't budge from its position, which one D.C. employee laid out for Thomas and Fox in an e-mail: "Adopted children are not treated as natural children."
In reporting the story, I had a very simple request for the D.C. Department of Human Resources (DCHR): To produce the D.C. government's policy for insuring adopted children.
Although such a policy is hardly sensitive information, and although it should be readily attainable by a DCHR public affairs officer, DCHR refused to answer my questions until I submitted a Freedom of Information Act request. I submitted the FOIA on Feb. 12, and DCHR took its time getting back to me—it took the agency fifteen business days, the maximum allowed, to cough up the policy. Finally, here's WTF is up with the D.C. Government's adoption policies:
1. When an employee adopts a child, what procedures are undertaken by the employee and DCHR in order to add the child to the employee's health insurance?
When a District of Columbia government employee adopts a child, the prospective adoptive parents have to file a health insurance enrollment form to add the child to their policy within sixty (60) days of the adoptive placement. The parents must provide evidence of the adoptive placement. DCHR receives the enrollment forms and documents submitted to make sure that they comply with District laws regarding adding children to the policy. If HR Specialists determine that the document is insufficient, then they are to request additional documents from the employee.
2. When an employee adopts a child, at what point does the child become eligible to be covered by the employee's health insurance plan?
When an employee adopts a child, coverage for the child will start from the date of the placement if the employee makes the request within sixty (60) days of adoption placement. If the employee does not submit the health benefit enrollment form and required doumentation within the special enrollment period (sixty (60) days of the placement), then they have to wait until Open Season Enrollment or when they have another qualifying life event.
3. Does the employee need to provide a court decree showing the Finalization of Adoption before the child may be eligible for health insurance coverage?
No, an employee does not need to provide a court decree showing the Finalization of Adoption before the child may be eligible for health insuarnace coverage.
4. How does DCHR determine a child's date of placement with its adopted family?
There is no one way to determine a child's date of placement; DCHR looks at many factors. One way for DCHR to determine a child's date of placement with its adopted family is from a court order placing custody or guardianship with the prospective adopted parents. Another way is pursuant to a legal agreement with a licensed privatized adoption agency, but only after the natural parents execute a witten consent to terminate their parental rights or a court grants guardianship/custody to the licensed private adoption agency or terminates their parental rights.
5. Please cite the federal and/or local laws the DCHR policy follows.
The federal and/or local laws that DCHR follows regarding this policy are, but are not limited to: D.C. Official Code section 1-621.07(c) and 1-621.13; District Peronnel Manual Instructions No. 21A-6 and 21B-11, and the applicable Internal Service regulations regarding special enrollment with respect to dependents. DCHR also use the Health Insurance Portability and Accountability Act (HIPAA), PL 104-191 as a guide regarding this policy.
In light of Thomas and Fox's ordeal, these answers raise a couple of concerns. First, if the D.C. government is following HIPAA provisions, according to adoption attorney Mark T. McDermott, it should be defining placement by the date the adoptive family becomes financially responsible for the child—not the date the natural parents terminate their parental rights, which can happen up to a month after the baby is born. Thomas and Fox were financially responsible for Max the second he exited the womb, and his medical bills began piling up at that moment.
Second: Are D.C. government employees even aware of these policies? Are they adhering to them? Or are they continuing to require parents to produce a finalization of adoption decree before their children receive health insurance, leaving families with months of uncovered medical expenses for their young children?