When adding a new dependent (spouse, domestic partner, child) to your health and/or dental insurance, you will be required to submit proof of their eligibility. Below it is broken up by type of dependent and what documents you will need to have a copy to upload to your "Verify Dependents" link in Employee Self Service. 

To find a printable version of the entire list below, please visit the Benefit Resources page >> Other Resources >> "DEV Required Documents List (printable pdf)"

Please note: any documents submitted to verify your dependent's eligibility must be in English.

Required Documents per Dependent

(2) Two documents required

  1. A copy of your marriage certificate or a completed Affidavit of Common Law Marriage. 
  2. AND one of the following:
    • A copy of the front page of your 2021 federal tax return (Form 1040) showing you filed as married jointly or married filing separately.
    • A document dated within the last 60 days, such as a recurring monthly utility bill, credit card bill, or account statement. The document must be current and list your spouse's name, your mailing address, and date. Note: Healthcare bills will not be accepted as proof of eligibility as healthcare coverage is being verified.
    • A copy of your spouse's state-issued ID that was issued within the last 60 days. The ID must be current and include your spouse's name, your mailing address, and the issue date.

Note: The mailing address listed on your spouse's documents MUST match the address we have on file for you here in the university system. 

All documents submitted must be in English. 

(2) Two to (3) Three documents required depending on what you choose to submit below

(2) Two of the following items, 1, 2, or 3:

  1. A copy of a document showing joint ownership of a residence (such as home, condominium, or mobile home mortgage statement or payoff) or a lease for a residence showing you and your partner as tenants.
  2. A copy of your life insurance, will, or retirement contract showing partner as a primary beneficiary.
  3. A copy of your relationship contract which obligates each of the parties to provide support for the other party and provides, in the event of termination of the relationship, for a substantially equal division of any property acquired during the relationship.

OR

(2) Two of the following plus 1 (one) from 1, 2, or 3 above:
If you choose this option, 3 (three) documents total are required for a complete submission.

  1. Joint ownership of a motor vehicle - a copy of the purchase agreement, car loan, or car registration
  2. Joint checking account - a copy of a recent statement dated within the past 60 days
  3. Joint credit card account - a copy of a recent statement dated within the past 60 days
  4. A copy of a Durable Power of Attorney for healthcare or financial management with your partner.

  1. A copy of the child's birth certificate, hospital birth record*, or adoption certificate naming you, your spouse, or your domestic partner as the child's parent.
  2. OR a copy of the court order naming you, your spouse, or domestic partner as the child's legal guardianship (up to age 18 only), 
  3. OR a copy of a Qualified Medical Child Support Order that requires you to cover your child. 

*Other hospital documentation may be acceptable, such as the discharge paperwork for MyChart visit documentation for the birth. Documentation must include the parent(s) and child's names. 

Note for Stepchild or Domestic Partner's Child:
If you cover a stepchild or partner's child, you must also provide documentation of your current relationship to the child's parent as requested above.

All documents submitted must be in English.

(2) Two documents required

  1. A copy of the child's birth certificate, hospital birth record*, or adoption certificate naming you, your spouse, or your domestic partner as the child's parent, 
  2. AND a copy of your child's student schedule for the current semester/quarter showing full-time enrollment in an accredited college or university.

*Other hospital documentation may be acceptable, such as the discharge paperwork for MyChart visit documentation for the birth. Documentation must include the parent(s) and child's names. 

Note for Stepchild or Domestic Partner's Child:
If you cover a stepchild or partner's child, you must also provide documentation of your current relationship to the child's parent as requested above.

(3) Three documents required

  1. A copy of the child's birth certificate, hospital birth record*, or adoption certificate naming you, your spouse, or your domestic partner as the child's parent,
  2. AND a copy of your most recent federal tax return (Form 1040) listing your child as a tax dependent, 
  3. AND a copy of your child's most recent Medicare statement or Social Security Administration statement showing your child is receiving benefits due to their disability. 

*Other hospital documentation may be acceptable, such as the discharge paperwork for MyChart visit documentation for the birth. Documentation must include the parent(s) and child's names. 

Note for Stepchild or Domestic Partner's Child:
If you cover a stepchild or partner's child, you must also provide documentation of your current relationship to the child's parent as requested above.