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1424 - Dependent Re-verification (DRV) (Historical View)

** Effective: 1/10/2018 10:47:17 AM - 1/10/2018 10:51:31 AM **

Status: Active

Change Notes

Resource updated: updated link

Category

Benefits and Insurance

Audience List

Synopsis

This policy

Introduction

The DRV is the process of re-verifying the eligibility of spouses, domestic partners, children, stepchildren, and domestic partner children (family members) for their continued enrollment for state health and dental benefits.  Government Code section 22843.1 mandates re-verifying the eligibility of these family members.  Government Code section 22959 authorizes extending this review to family members enrolled for dental benefits.

Statement

The DRV will begin in 2018.  The eligibility of family members will be re-verified once every three years.  The re-verification period is based on the employee's birth month.  The following chart illustrates the schedule:

Year of Re-verification

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

Employees enrolling family members within six months of their birth month will re-verify their eligibility at the next cycle.  Example:  An employee with the August birth month enrolls a spouse in May 2019.  The eligibility of this spouse will be re-verified in 2022.

* The DRV function in mylCalPERS will activate in February 2018.  Employees with the January birth month will initially re-verify their family members in 2021.

Employee Notification Process

Ninety (90) calendar days before the first of the month following the employee’s birth month (re-verification due date), CalPERS will send a letter to the employee providing the re-verification due date, and listing the enrolled family members for re-verification and the acceptable re-verification documents.  Employees are to promptly provide re- verification documents to, and complete the Dependent Eligibility Verification Checklist (CalHR Form 781) with, their Personnel Specialists.  Personnel Specialists are to re-verify the same family members for dental benefits, if enrolled.

Required Re-verification Documents

Employees should provide copies of the following re-verification documents and write “Not for Official Use” on them:

Required Re-verification documents
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 subscriber’s federal or state income tax return from the previous tax year listing the subscriber 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 subscriber 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.

In subsequent re-verifications, employees need not provide birth certificates for natural-born children or adoption certificates for adopted children again, unless requested by the HR office.  They 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, unless requested.

HR Responsibility

Within 30 calendar days of receiving the re-verification documents, HR offices are to review and determine if they support the continued enrollment of the family members.  If they do, HR offices are to key in mylCalPERS that the dependents are re-verified.  If the documents do not support the continued enrollment of the family members, HR offices are to inform the employees in writing, i.e., by email, that the documents are deficient and the employee will need to provide documents that demonstrate a family member relationship still exists.  HR Offices shall monitor employee responses and health event changes in the CalPERS “Dependent Verification Health Event Report.”  If CalPERS removes family members from health benefits, HR offices are to remove the same dependents from dental and premier vision benefits, if enrolled. 

Delay in re-verifying the eligibility of family members may result in their loss of health, dental, or vision coverage.

Human resource (HR) offices are to keep all documents used in the DRV process in the employee’s Official Personnel Files (OPF) without a purge date.

The “Dependent Verification End Date Report” will be available in mylCalPERS for HR offices to see the employees whose family members require re-verification in the current year.  HR offices can inform these employees in advance to gather the re-verification documents and submit them when officially notified by CalPERS.

Consequences

Disenrollment from Health and Dental Benefits

If employees do not respond or provide the required documents during their re-verification cycle, CalPERS will remove dependents from health benefits effective the first of the month after the employee’s birth month.  HR offices are to monitor health benefit deletions by regularly viewing the CalPERS “Dependent Verification Health Event Report,” and remove the same dependents from dental and vision benefits, if enrolled. 

CalPERS will inform employees during their birth month in writing if administratively removing their family members from health benefits.  CalPERS will include Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation of coverage information with this letter.  

HR offices are to inform employees in writing, within 14 days from their dependent deletion, explaining the same family members are removed from dental and/or premier vision benefits, and the effective date(s), if enrolled.  HR offices shall include COBRA information with this letter.

Disenrollment from Dental or Premier Vision Benefits

HR offices are to establish a method to track employees with family members enrolled in dental and/or premier vision benefits only, and re-verify their eligibility for continued coverage once every three years, following the DRV schedule.

When removing ineligible family members enrolled for dental or premier vision benefits, HR offices are to inform employees in writing indicating the family members to be disenrolled and the effective date(s).  HR offices shall also provide COBRA information to the family members within 14 days from their loss of coverage.

Employees Providing Re-verification Documents Untimely

If employees provide re-verification documents for disenrolled, eligible dependents after receiving the final CalPERS notice during their birth month but before the re-verification due date, HR offices may rescind the dependent deletion.  EMPLOYEES MAY INCUR AN ACCOUNTS RECEIVABLE FOR THE PREMIUM FOR THE MONTH AFTER THEIR BIRTH MONTH. 

If employees provide re-verification documents for disenrolled, eligible dependents after the re-verification due date, HR offices re-enroll the family members prospectively for health and/or dental benefits using the “Add Dependent—Re-enrollment of Verified Dependent” code.  THIS WILL RESULT IN A GAP OF BENEFIT COVERAGE.

Other Events Coinciding with Re-verification Cycle

Children Reaching Age 26

If a child's 26th birthdate coincides with the employee’s re-verification cycle, CalPERS will administratively remove the child from health benefits upon the child turning age 26.  The employee should inform the HR office to remove the child from dental and premier vision benefits, if enrolled.  The best practice is for HR staff to view regularly the CalPERS “Dependent Verification Health Event Report” to disenroll ineligible health dependents from dental and premier vision benefits.

Permissive Deletions

Employees should contact their HR offices immediately if they wish to remove a dependent due to a “permissive qualifying event” (e.g., family member obtains non-state sponsored 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.

Mandatory Deletions

Employees should notify their HR offices immediately of any qualifying event that occurs during their 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.

PCR Dependent or Disabled Child Age 26 and Over Recertification

The DRV is separate from the annual process to recertify a PCR dependent or a disabled child age 26 and over.  If employees receive notices to recertify PCR dependents during their DRV cycle, they should follow the instructions on these notices to recertify PCR dependents.

Employee Contact

Employees should contact their departmental HR offices with questions regarding the DRV.  If the employee disagrees with the HR decision on the re-verification of their family members, they must submit their reasoning for disagreement, in writing, to the departmental contact.  If the departmental contact cannot resolve the issue, they may submit a copy of the written disagreement to CalHR at DRV@calhr.ca.gov for review.

Application

Not Applicable.

Authorities

Resources

FAQs

Forms

Related Policies

Web Pages

Contact Person

Scott Morrison
DRV Program Manager , Benefits Division
Phone: 916-322-3657
Fax: 916-322-3769
Email: scott.morrison@calhr.ca.gov

Authorized By

Ralph Cobb
Chief (Acting), Benefits Division