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Department of Human Resource Management
Office of State Health Benefits
April 10, 2026
Clarification of Adoption Events vs. Judgement, Decree or Order Events
The Office of Health Benefits (OHB) has recently experienced an increase in inquiries regarding when it is appropriate to use an Adoption or Placement of Adoption event versus a Judgement, Decree or Order event to enroll a dependent. The following guidance is provided to clarify these two events.
Birth, Adoption or Placement for Adoption
Gaining a new dependent, as a result of birth, adoption, or a placement for adoption is a qualifying mid-year life event. Unlike other qualifying mid-year life events, coverage is retroactive to the date of birth, adoption, or placement.
- When an employee submits a request that includes documentation of the final adoption agreement, the “Adoption” event should be selected in the Benefit Event Tool in Cardinal.
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Pre-adoption (placement for adoption) agreements must be sent to OHB for review prior to enrollment.
Judgement, Decree or Order
A judgement, decree or order qualifying mid-year life event allows a change to the employee’s health coverage based on a legal directive from a court for the employee and/or legal spouse to provide health coverage for a dependent. This may have resulted as a part of a final divorce decree or obtaining sole permanent custody of an “other child”. The order is issued directly to the employee, not served on the agency.
- When an employee and/or legal spouse obtains sole permanent custody of an “other child”, the event “Judgement, Decree or Order to add child” should be selected in the Benefit Event Tool in Cardinal.
Note:
The Department of Social Services/DSS orders and National Medical Support Orders/NMSO are issued directly to the agency and have their own separate event drop-down selection in the Benefit Event Tool in Cardinal.
Express Script’s vendor, Berkeley Research Group, LLC. Breach May Impact Commonwealth of Virginia Advantage 65 Members
On March 12 ,2026, the Department of Human Resource Management (DHRM) Office of Health Benefits was notified by Express Scripts (ESI) of an incident involving their vendor, The Berkeley Group, LLC (BRG). ESI provides the Medicare Part D Prescription Drug Plan for Advantage 65 members.
BRG, a vendor who provides data consulting and litigation support services, in connection with their business operations for Express Scripts, detected unusual activity within its systems occurring between February 28 and March 2, 2025. After discovering the activity, BRG implemented containment measures and initiated an investigation. BRG also notified and cooperated with federal law enforcement and the appropriate regulatory authorities. The investigation and full analysis were completed in November 2025. It was determined that the incident was limited to BRG’s systems and did not impact any of Express Scripts systems.
Here is the pertinent information from The Berkeley Group, LLC., at this time:
- Social Security numbers and financial information may have been impacted by this incident.
- The investigation to date indicates that the information accessed may have included member names, contact information, addresses, dates of birth, social security numbers, health plan identification numbers, health plan name, group numbers, financial information, clinical or treatment information, medical record numbers, prescription details, and payment history. The specific information impacted varies by individual, and not all data elements were involved for every person.
BRG will be mailing notices to impacted members. No action is required by agencies at this time. DHRM will continue to monitor the situation and provide updates to agencies and localities as needed.
For more information or questions regarding this incident, members should call
The Berkeley Group, LLC toll-free assistance line at (866) 291-2114 Monday through Friday, from 9:00 a.m. to 6:30 p.m. Eastern Time (excluding U.S. holidays).
Additionally, they have secured the service of Kroll to provide identity monitoring at no cost for twenty‑four (24) months, including credit monitoring, fraud consultation, and identity theft restoration. Members can visit info.krollmonitoring.com for information on their services.
Visit https://enroll.krollmonitoring.com to activate and take advantage of your identity monitoring services.
Virtual programs for COVA Care, COVA HDHP and COVA HealthAware Members Contact Information
In addition to the information provided in the E-News dated March 25, 2026, introducing the new virtual programs beginning April 1, the following are their contact details that may be shared with employees, enrolled in the health plans listed above.
Hinge: 855-902-2777; help@hingehealth.com
Hello Heart: 800-767-3471; support@helloheart.com
Virta: support@virtahealth.com
Thank you.
Please do not reply to this e-mail. You may send inquiries to the Office of Health Benefits mailbox at ohb@dhrm.virginia.gov.
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