In order to cover your spouse under a Children's of Alabama Medical Plan, you must provide a Spouse Affidavit upon initial eligibility AND again during EACH Open Enrollment.  The form is provided below.  

If your spouse is employed, their employer must complete and sign the Spouse Affidavit.  If your spouse is eligible for their employer's medical plan AND that employer pays at least 50% of the premium for individuals, then your spouse can be covered as primary under a COA medical plan.  This form is NOT required for coverage under any other COA benefit.  Your spouse may be eligible for secondary coverage under our  medical plan if you provide proof of his/her primary coverage. 

E-mail the completed form to [email protected].  It must be received within 30 days of the requested coverage date or by the stated deadline for Annual Open Enrollment.