Dependent Verification

You must provide the following documents in order to complete the Dependent Verification:

Dependent Spouse Marriage Certificate along with a copy of the front page of your 2023 federal tax return confirming this dependent is your spouse (please black out all financial information); or if you have not yet filed your 2023 federal tax return, in the interim you may provide a copy of your 2023 tax return extension form showing your spouse’s Social Security Number; however, you must provide the front page of your 2023 federal tax return no later than November 15, 2024 in order to complete the DVI process.

Domestic Partner Domestic Partnership Affidavit (Form available in the Documentation Section) and two documents constituting proof of joint living

Dependent Child

• Natural Child up to age 26 – Birth Certificate
• Adopted Child – Adoption paperwork
• Stepchild – Birth Certificate, Marriage Certificate and a copy of the front page of your 2023 federal tax return confirming your stepchild’s natural parent is your spouse (please black out all financial information); or if you have not yet filed your 2023 federal tax return, in the interim you may provide a copy of your 2023 tax return extension form showing your spouse’s Social Security Number; however, you must provide the front page of your 2023 federal tax return no later than November 15, 2024 in order to complete the DVI process.
• Disabled Child over age 26 – Birth Certificate and Doctor’s Certification of Disability or Social Security Disability Award

Please note:  If you do not file taxes, the Plan will accept an Affidavit from you confirming the validity of your dependents (form linked below).

You must provide the following documents for new dependents you are enrolling:

Natural Child: Birth Certificate.

Stepchild: Birth Certificate and Marriage Certificate showing you are married to the child’s natural parent.

Adopted Child: Adoption paperwork which lists adoptive parents,

Spouse: Marriage Certificate.

Our enrollment department will advise you if any additional documentation is needed.

Documents Section

Domestic Partnership Affidavit

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