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

** Effective: 9/17/2018 8:29:46 AM - 9/17/2018 9:08:59 AM **

Status: Active

Change Notes

Added CalPERS Circular Letter 600-040-18 resource.

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, dental, and premier vision 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 in dental benefits.

Statement

The DRV began 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.

* Employees with the January birth month will initially re-verify their family members in 2021.

Employee Notification Process

Ninety (90) calendar days before the employee’s birth month, CalPERS will send a letter to the employee informing them of the re-verification requirement. The letter will provide the re-verification due date, and a listing of the family members enrolled in health benefits, and the acceptable re-verification documents. Two additional reminder letters will be sent to employees 60 and 30 days prior to the re-verification due date. Employees are to promptly provide re-verification documents and a completed Dependent Eligibility Verification Checklist (CalHR Form 781) to their HR office.

Additionally, departmental HR offices are to send a letter to employees informing them of the re-verification requirement of family members enrolled in dental and Premier vision benefits. The letter should include the re-verification due dute, a listing of family members enrolled in dental and/or Premier vision benefits, and the acceptable re-verification documents. Notification to employees in dental and Premier vision benefits should follow the same three-month schedule as the health notices provided by CalPERS  (Refer to CalPERS Circular Letter #600-040-18). Employees are to promptly provide re-verification documents and a completed Dependent Eligibility Verification Checklist (CalHR Form 781) to their HR office. Departmental HR staff may use the notification templates provided in the Dependent Re-Verification Toolkit.

Employees are only required to submit one completed Dependent Eligibility Verification Checklist (CalHR Form 781) to their HR Office to verify eligibility of their family members enrolled in health and dental and/or Premier vision benefits.

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 government issued 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 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. They also need not provide the government issued marriage certificate, domestic partnership registration, and birth certificates for stepchildren or domestic partner children if the marriage or domestic partnership remains current, unless requested.

Employees are responsible for redacting sensitive information, not necessary for dependent re-verification purposes, from any applicable documents (such as tax returns).

HR Responsibility

Within 30 calendar days of receiving the re-verification documents from employees, HR offices are to review and determine if the documents support the continued enrollment of their family members in health, dental, and Premier vision benefits. If they do, HR offices are to key in mylCalPERS that the dependents are re-verified to continue enrollment in health benefits. No further action is required for re-verified dependents enrolled in dental or Premier vision benefits.

If the documents do not support the continued enrollment of the family members, HR offices are to inform the employees in writing, (i.e., first class mail, email) that the documents are deficient and the employee will need to provide documents that demonstrate a family member relationship still exists. CalPERS will automatically administratively disenroll ineligible dependents from health benefits. Departmental HR office shall administratively disenroll them 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 Premer vision benefits.

Departmental 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 for health benefits 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.

The Dependent Re-Verification Toolkit provides an enrollment tracking sheet to assist departments in tracking enrollment of dependents enrolled in dental and/or Premier vision benefits, or they may use CalHR’s Dependent Extranet.  

Consequences

Disenrollment from Health 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.”

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.  

Disenrollment from Dental or Premier Vision Benefits

If employees do not provide the required documents during their re-verification cycle, Departmental HR offices are to administratively disenroll their dependents from dental and/or Premier vision benefits effective the first of the month after the employee’s birth month. When removing ineligible family members from 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. Permitting event codes:

Dental Permitting Event Code – 13D

Vision Permitting Event Code– 14D

 

Employees Providing Re-verification Documents Untimely

If employees provide re-verification documents for disenrolled, eligible dependents after receiving the final CalPERS notice but before the re-verification due date, HR offices may rescind the dependent deletion from health benefits. 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 must re-enroll the family members prospectively for health, dental, and Premier vision benefits. THIS MAY RESULT IN A GAP OF BENEFIT COVERAGE. Permitting event codes:

my|CalPERS – “Add Dependent—Re-enrollment of Verified Dependent” code.

Dental Permitting Event Code – 13A

Vision Permitting Event Code– 14A

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, if enrolled.

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 process to recertify a PCR dependent annually 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

Authorized By

Machelle Martin
Chief, Benefits Division

Contact Person

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

Superseded Policies

Not Applicable.