ATTENTION CCPOA MEMBERS
CalPERS is requiring Re-Veriﬁcation of Dependents
To ensure only eligible dependents of State employees are enrolled in employer-sponsored health coverage, California Government Code Section 22843.1 requires your employer to verify the eligibility of your dependent(s) at least once every three years.
- Sixty (60) calendar days before your birth month, CalPERS will send you a letter providing the re-verification due date, listing the enrolled family members for re-verification and the acceptable re-verification documents.
- You are to promptly provide re-verification documents to, and complete the Dependent Eligibility Verification Checklist (CalHR Form 781) with, your Personnel Specialist.
- The Personnel Specialist will re-verify the same family members for dental and premier vision benefits, if enrolled.
- Delay in providing re-verification documents to your departmental human resources (HR) office may result in your family members losing health, dental, and/or premier vision coverage.
The re-verification period is based on your birth month. The following chart illustrates the schedule:
What Do You Do?
If you have received a cancellation notice, contact your HR Department ASAP
What Do You Need?
If you have previously provided the required documentation to verify each dependent’s eligibility, the documentation must be provided again to comply with this new requirement.
Dependents who require verification:
- Current spouse
- Current domestic partner as registered with the California Secretary of State’s Office
- Natural-born, adopted (or placement for adoption), current step, or current registered domestic partner children up to age 26.
Make copies of any required verification documents listed below for each dependent.
Provide all required documents to your agency’s personnel office.
Acceptable Verification Documents
A copy of your marriage certificate AND one of the following documents:
|Registered Domestic Partner||
A copy of your Declaration of Domestic Partnership registered with the California Secretary of State AND one of the following documents:
|Children (natural-born, adopted, placement for adoption, step, or registered domestic partner’s children) up to age 26 (the month in which dependent attains age 26)*||
* For a stepchild, or domestic partners child, you must also provide documentation of your current relationship to your spouse or domestic partner as requested above.