The Dependent Re-verification (DRV) is the process of re-verifying the eligibility of spouses, domestic partners, children, stepchildren, and domestic partner children (family members) enrolled in 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 in dental benefits. The bargaining unit contracts specify that your family members’ eligibility for dental benefits shall be the same as that prescribed for health 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:
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.
* If January is your birth month, you will initially re-verify your family members in 2021.
Ninety (90) calendar days before your birth month, CalPERS will send you a letter providing the re-verification due date, listing the family members enrolled in health benefits, for re-verification and the acceptable re-verification documents. If you have dependents enrolled in dental benefits, your HR office will send you a letter providing the re-verification due date, a list of enrolled family members, and the acceptable re-verification documents.
You are to promptly provide re-verification documents to, and complete the Dependent Eligibility Verification Checklist (CalHR Form 781) with, your Personnel Specialist.
Delay in providing re-verification documents to your departmental human resources (HR) office may result in your family members losing health and/or dental coverage.
HR offices will keep all documents used in the DRV process in your Official Personnel File (OPF) without a purge date.
You may contact your HR office or visit the dental carrier website and create an online profile. From your online profile, you can view who is enrolled on your plan. Below is a list of the carrier websites:
No. You should provide copies of the documents and write "Not for Official Use" on them.
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.
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.
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.
A copy of the birth certificate naming the employee as the parent.
A copy of the adoption certificate naming the employee as the parent.
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 (e.g., marriage or registering as domestic partners), while the second required document substantiates that the relationship is current.
If an employee attempts to re-verify their spouse or registered domestic partner through documentation other than tax returns, one or more documents may be needed to substantiate that the relationship still exists.
Scenario 1: Linda Smith is a state employee and is currently enrolled in state-sponsored health benefits. Her spouse, John, is listed as a dependent on her health plan. Linda provides HR staff with a household billing statement, dated within 60 calendar days of submission to HR. The statement lists both Linda and John, as well as their common address. This one statement may be considered substantial evidence to re-verify.
Scenario 2: Aaron Williams is a state employee and is currently in state-sponsored health benefits. His spouse, Erica, is listed as a dependent on his health plan. The Williams’ prefer to keep their finances separate, so Aaron provides HR staff with two separate household billing statements, both dated within 60 calendar days of submission to HR. One statement is billed to Aaron and the other to Erica. If both statement addresses are the same, then these statements may be considered substantial evidence to re-verify.
Yes. Employees are responsible for redacting sensitive information, not necessary for dependent re-verification purposes, from any applicable documents (such as tax returns).
No. You will be responsible for any charges 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 HR office to re-verify your family members. HR offices will keep all documents used in the DRV process in your OPF 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 government issued marriage certificate, domestic partnership registration, and birth certificates for stepchildren or domestic partner children, unless requested. However, you are required to provide documents to demonstrate that 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 HR office during your re-verification cycle, CalPERS will remove your family members from health benefits. Your HR 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 disenrollment of your family members is effective the first of the month after your birth month.
Your HR office will inform you in writing explaining they are removing the same family members from dental benefits and the effective date, if enrolled. Your HR office will include COBRA information for dental benefits.
Your HR office will track your family members who are enrolled in dental benefits, and re-verify their eligibility for continued coverage once every three years, following the DRV schedule.
If your HR office removes your family members who are enrolled in dental benefits, your HR office will inform you in writing who will be disenrolled 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, but before the re-verification due date, your HR office may rescind the dependent deletion. You may incur an accounts receivable for the premium for the month after your birth month. If you provide re-verification documents for disenrolled, eligible dependents after the re-verification due date, your HR office re-enrolls the family members prospectively for health and/or dental. THIS WILL RESULT IN A GAP OF 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. You should inform your HR office to remove your child from dental benefits, if enrolled.
You should contact your HR office immediately if you 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.
The DRV is separate from the process to recertify a PCR dependent or a disabled child age 26 and over. Follow the instructions provided to you by CalPERS to recertify these dependents.
Notify your HR 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 "State Health Benefits Guide" contains health benefit information. The CalHR Dental Program website contains dental benefit information.
You can contact your departmental HR offices.
You must contact your departmental HR office with questions regarding dependent re-verification. If you disagree with the HR decision on the re-verification of your family members, you must submit your reasoning for disagreement, in writing, to the departmental contact.