When a new child joins the family, you should evaluate your benefit selections to make sure they meet the needs of you and your family. This overview is designed to highlight the options available to you. Additional information is available on the Benefits website or from the Human Resource Information Center (HRIC) at 684-5600.

What changes can I make? Whose health insurance policy will cover the child?

An employee who is otherwise eligible, but not enrolled for coverage, can enroll (and can also enroll a spouse and any new dependents, if they are otherwise eligible under the plan) when a birth, adoption or placement for adoption occurs. You can increase your coverage to cover your dependent(s), drop coverage at Duke if you are choosing coverage under a non-Duke health plan, or change your plan, i.e. change from Duke Basic to Duke Select.

Beyond comparing premium and other cost differences in choosing whose health insurance plan will cover the baby, consider the following:

  • Which plans your selected pediatrician participates in
  • Whether the non-Duke policy provides pre- and post-natal obstetrical care, well-baby and well-child care and routine immunizations
  • How deductibles and copayments, including those for prescriptions, compare with the Duke policy

When should I add the baby to my coverage?

You must enroll with the HRIC within 30 days of the date of birth or adoption. Coverage for newborns and any other newly enrolled subscribers begins on the baby’s date of birth. Premiums are not pro-rated.

Can I enroll in coverage?

An employee who is otherwise eligible, but not enrolled for coverage, can enroll (and can also enroll a spouse and any new dependents, if they are otherwise eligible under the plan) when a birth, adoption or placement for adoption occurs.

Should I change health plans?

You may decide that your current health plan is not a good choice now that you have a baby. This qualifying event allows you to change to a plan that better fits your needs. Any changes made will take effect on the new dependent’s date of birth/adoption, and since premiums are not pro-rated, you will owe the difference in premiums for the month of the birth or adoption. If you have questions about how timing impacts changes to your benefits premiums, please contact the HR Information Center at 919-684-5600.

Do I need to increase the amount of my life insurance coverage?

Employees with young families and with high long term debt, such as a mortgage, may need more life insurance to provide financial security for surviving family members than employees with grown children and less long term debt. If you divide the amount of your current life insurance coverage by your take-home pay, you will know how many pay periods your present level of earnings would continue to support your household. If this figure is not sufficient in dollar amount or duration to support your household, you may wish to increase your life insurance coverage.

If you determine that you need to increase your coverage, there are a number of life insurance options available. For example, with Personal Accident (AD&D) Insurance you can purchase a high coverage amount at a low cost, but benefits will only be paid in the event of accidental death. You can also purchase Supplemental Life insurance which will provide benefits in the event of death from illness and natural causes. The premiums are higher for Supplemental Life insurance than AD&D. For more information, please see the Life Insurance website.

Should I change my beneficiary designations?

You may want to consider changing your beneficiary designations under your life insurance and retirement programs. The HRIC or specific program vendors can provide assistance. Additionally, you may want to consider obtaining legal counsel if you will be establishing or amending a trust fund or will.

What if I will be using day care or will have a predictable increase in my out-of-pocket medical expenses?

You should consider enrolling in or increasing your deduction for your Duke reimbursement accounts. Since account contributions are made with before-tax dollars, reimbursement accounts provide ways to reduce your taxable income. The amounts credited to your account are reimbursed to you when you submit a claim for a qualified expense. The increase to your reimbursement account or enrollment in the program must be made within 30 days of the family status change.

For the Health Care Reimbursement Account, enrollment or changes must occur within 30 days after the child is born or the employee returns to work. The payroll deduction may continue and claims can be reimbursed even while a parent is home with the new baby.

For the Dependent Care Reimbursement Account, enrollment or changes must occur within 30 days after the second parent has returned to work or school full time. The IRS does not allow reimbursement for expenses incurred while either parent is not actively at work. If you are currently using the dependent care reimbursement program for another child, please contact the HRIC to discuss having your deductions stopped while on leave for the new baby as well as to restart the account once both parents are working or attending school full time. Remember, the 30 day enrollment or change period begins the date that the second parent returns to work.

Your reimbursement account contribution amount can only be changed if there is a subsequent change in family circumstances or the amount of your daycare expense changes and the change requested is consistent with that change. Additionally, any amount greater than $500 left in the Health Care Reimbursement Account at the end of the plan year is forfeited. For these reasons, you may want to be conservative in estimating your anticipated expenses.

I have an existing Reimbursement Account. What do I need to know?

While you are on leave with the new baby, you can continue Duke payroll deductions for your Health Care Reimbursement Account and continue to submit claims for eligible expenses incurred. If you have a Dependent Day Care Account, you should be aware that:

  • The maximum annual amount you can deposit into the account is $5,000. The $5,000 is a cumulative family maximum between both parents. There is also a corresponding maximum deduction amount per paycheck.
  • The IRS rules prohibit claiming reimbursement for any day care expenses incurred while either spouse is not working. For example, if you have two children and your older child is in day care while either you or your spouse is on leave, the expenses incurred during this time frame for the older child's day care expenses are not eligible for reimbursement since one parent is not working or a full time student.
  • If you will not be working during your leave, consider stopping your deductions for your dependent day care account when you begin your leave. Your deduction is not stopped automatically, please contact the HRIC for assistance.
  • You can restart the deduction by notifying the HRIC in writing within 30 days of the second parent's return to work.

I'm looking for day care providers. Can you provide referrals?

You can find a list of child care resources at the Family-Friendly Benefits website.


The "life event series" overview is intended to highlight some of the benefit options to be considered due to a change in family status. It is not designed to substitute for an official plan document. If there is a conflict between this web site and the official plan documents, the official plan documents will govern in all cases. Duke reserves the right to change or terminate these plans or your eligibility for benefits under the plans at any time.