Health Care Dependent Re-Verification

Employees Re-Verifying Family Members

The Dependent Re-verification (DRV) is the process of re-verifying the eligibility of your spouse, domestic partner, children, stepchildren, and domestic partner children (family members) enrolled for state health and dental benefits. Government Code section 22843.1 mandates re-verifying the eligibility of your family members.  Government Code section 22959 authorizes extending this review to your family members enrolled for dental benefits.

The eligibility of your family members will be re-verified once every three years.  The re-verification period is based on your birth month. The following chart illustrates the schedule:

Year of Re-Verification

 

2018

2019

2020

2021

2022

2023

Employee

Birth

Month

 

April

July

October

February

May

August

November

March

June

September

December

January*

April

July

October

February

May

August

November

March

June

September

December

This three-year cycle repeats. If you enroll family members within six months of your birth month, their eligibility will be re-verified at your next cycle. Example: If August is your birth month and you enroll a spouse in May 2019, the eligibility of your spouse will be re-verified in 2022.

* The DRV function in mylCalPERS will activate in February 2018. If January is your birth month, you will initially re-verify your family members in 2021.

The following Frequently Asked Questions are to assist you in complying with this mandate:

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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 your campus benefit office. The benefit office will re-verify the same family members for dental benefits, if enrolled.

Delay in providing re-verification documents to your benefit office may result in your family members losing health and/or dental coverage.

Benefit offices will keep all documents used in the DRV process in your benefit file without a purge date.

You should provide copies of the documents and write "Not for Official Use" on them.

Dependent Type

Required Re-verification Documents

Spouse or Domestic Partner

A copy of the marriage certificate or domestic partnership registration filed with the California Secretary of State or a comparable agency in another jurisdiction listing the family member as the domestic partner.

 

AND

 

A copy of the first page of the employee's federal or state income tax return from the previous tax year listing the employee and the spouse or domestic partner.

 

OR

 

A combination of other documentation, including but not limited to, a household bill, account statement, or insurance policy listing the name and address of the employee and the spouse or domestic partner, or other documents that substantiate the existence of a current marriage or domestic partnership. Household bills and account statements older than 60 calendar days are unacceptable.

Natural-born Children

A copy of the birth certificate naming the employee as the parent.

 

Adopted Children

A copy of the adoption certificate naming the employee as the parent.

 

Stepchildren

A copy of the birth certificate naming the employee's current spouse as the parent.

 

Domestic Partner Children

A copy of the birth certificate naming the employee's current domestic partner as the parent.

 

The first document establishes the life event allowing the enrollment of the dependent (i.e., marriage or registering as domestic partners), while the second required document substantiates the relationship is current.

You will be responsible for any charge related to obtaining copies of the required documents.

Providing a copy of the documents for the initial DRV cycle will enable a more direct process for your campus benefit office to re-verify your family members. Benefit offices will keep all documents used in the DRV process in your benefit file without a purge date. In subsequent re-verifications, you need not provide birth certificates for natural-born children or adoption certificates for adopted children again. You also need not provide the marriage certificate, domestic partnership registration, and birth certificates for stepchildren or domestic partner children if the marriage or domestic partnership remains current.

HMS securely destroyed the documents received during the DEV project to protect the privacy of you and your family members.

If you do not respond or provide the required documents to your benefit office during your re-verification cycle, CalPERS will remove your family members from health benefits.  Your benefit office will remove the same family members from dental benefits, if enrolled. 

CalPERS will inform you during your birth month in writing if administratively removing your family members from health benefits. CalPERS will include Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation of coverage information with this letter.  The dis-enrollment of your family members is effective the first of the month after your birth month.

Your campus benefit office will inform you in writing explaining they are removing the same family members from dental benefits and the effective date, if enrolled. Your benefit office will include COBRA information for dental benefits.

Your benefit office will track your family members who are enrolled for dental benefits only, and re-verify their eligibility for continued coverage once every three years, following the DRV schedule.  

If your benefit office removes your family members who are enrolled for dental benefits only, your benefit office will inform you in writing who will be dis-enrolled and the effective date, and provide you COBRA information.

If you provide re-verification documents for dis-enrolled, eligible dependents after receiving the final CalPERS notice during your birth month but before the re-verification due date, your campus benefit office may rescind the dependent deletion. YOU MAY INCUR AN ACCOUNTS RECEIVABLE FOR THE UNPAID PREMIUM FOR THE MONTH AFTER YOUR BIRTH MONTH.   

If you provide re-verification documents for dis-enrolled, eligible dependents after the re-verification due date, your benefit office re-enrolls the family members prospectively for health and/or dental benefits. THIS WILL RESULT IN A GAP IN THE DEPENDENTS BENEFIT COVERAGE.

If your child's 26th birth date coincides with your re-verification cycle, CalPERS will administratively remove your child from health benefits on the birth date.  Your benefit office will remove your child from dental benefits, if enrolled. 

You should contact your benefit office immediately if you wish to remove a dependent due to a "permissive qualifying event" (e.g., family member obtains non-CalPERS health benefits, family member enters military, custody change for child under age 18, or child reaches age 18). The dependent should be removed due to a qualifying permissive event rather than ineligibility found during the re-verification process.

The DRV is separate from the process to recertify a PCR dependent or a disabled child age 26 and over. Follow the instructions on these notices to recertify these dependents.

Notify your benefit office immediately of any qualifying event that occurs during the re-verification period, such as divorce or termination of domestic partnership. In these situations, the dependent should be removed due to the qualifying event rather than ineligibility found during the re-verification.

The CalPERS website contains health benefit information. Your campus benefit website contains dental benefit information.   You also may obtain dental benefit information on the CSYou Intranet site at csyou.calstate.edu.

You can contact the Payroll and Benefits Office at 4-2793 or payroll@sonoma.edu.