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. To view plan coverage, please go to the Active Member Benefits Main Page.
When filing a Maternity/Adoption Claim, all paperwork (the Claim Form, a copy of the Birth Certificate or Adoption Papers etc.) should be submitted to COBANC. An original signed and dated Health & Welfare Enrollment/Update Form must be submitted with the claim. Once we have enrolled your new dependent for coverage, we will forward the claim to Healthplex for processing.
Maternity/Adoption Claim Form
(It is preferable that you fill out these forms electronically, then print, sign and date before submitting them. If you hand-write, please print legibly.)