Dependent Audit

A person to whom the member is legally married (same or opposite gender if applicable).A legally separated or ex-spouse may not be an eligible dependent. This is based on the Plan Document.

• Marriage Certificate (issued by state, county or vital records office, not the ceremonial copy). If you do not have the certificate in your own records, you may be able to order it online here: https://www.vitalchek.com/marriage-records

AND ONE of the following:

• Page 1 and signature page of member’s Federal Income Tax Return, as filed with the IRS, listing the spouse
• Page 1 and Certificate of Electronic Filing of member’s Federal Income Tax Return, as filed with the IRS, listing the spouse
• Current mortgage statement, home equity loan, lease agreement, or current Property Tax documents
• Automobile registration that is currently in effect under both names (member and spouse)
• Current credit card statement or bank account statement or utility bill under both names (member and spouse)
• Current designation as the primary beneficiary for life insurance or retirement benefits, or primary beneficiary designation under a member’s will
• Assignment of durable property power of attorney or health care power of attorney

NOTE: “Current” is defined as within the last 12 months.

A biological (natural) child of the member.

• Birth Certificate (issued by state, county or vital records office, not the hospital certificate). If you do not have the certificate in your own records, you may be able to order it online here: https://www.vitalchek.com/birth-certificates

A legally adopted child or a child placed with the member in anticipation of legal adoption.ONE of the following legal documents:

• Certificate of adoption (court documents) signed by a judge showing that the participant has adopted the child
• Papers from the adoption agency showing intent to adopt
• International adoption papers from country of adoption
• Birth Certificate (issued by a state, county, or vital records office naming the adopted parents)

Your stepchild. You must be married to the child’s biological (natural) parent.

• Marriage Certificate (indicating member’s spouse is married to member)
• Birth Certificate of stepchild (issued by a state, county or vital records office) listing spouse

A child for whom the member has become the child’s court-ordered guardian.

• Court documents signed by a judge verifying legal custody
• Letter of guardianship issued by County Clerk

Any child the member is required to cover due to a Qualified Medical Child Support Order (QMCSO).

• Court documents signed by a judge
• Medical support orders issued by a State agency Parts A/B

An unmarried child who falls under one of the previously listed categories and who, due to a mental or physical disability, is unable to earn a living.

• The required document(s) for one of the dependent categories as noted above

AND ONE of the following:

• Letter of medical necessity from the attending physician to include diagnosis, specific explanation of disability, current functional deficits, the age the disability began prognosis and plan of care
• Notice of Determination from the Social Security Administration