Active Member Maternity/Adoption Benefit

COBANC provides a maternity/adoption benefit for Active Members and their eligible dependents. This benefit will be paid according to the schedule listed in the Active Member Supplemental Benefits Plan. A link to the Plan can be found below.

Claims Processing

When filing a Maternity/Adoption Claim, all paperwork (the Claim Form, a copy of the Birth Certificate or Adoption Papers, and an original signed and dated Health & Welfare Enrollment/Update Form) should be submitted to COBANC. Once we have enrolled your new dependent for coverage, we will forward your claim to Healthplex for processing.

Click or tap a link below to view or download
Active Member Supplemental Benefits Plan

Enrollment/Update Form

Maternity/Adoption Claim Form (It is preferable that you fill out this form electronically, then print, sign and date it before submitting it. If you hand-write this form, please print legibly.)