CalPERS

FAQs - Defense of Marriage Act One-Time Exception Enrollment

On June 26, 2013, the United States Supreme Court struck down the portion of the Defense of Marriage Act (DOMA) that barred same-sex married couples from recognition as spouses. With this ruling, an impediment to same-sex marriages was removed which may cause some couples to reconsider enrolling their eligible spouses and children in CalPERS health plans.

CalPERS is offering a one-time exception enrollment for employees and retirees who married during the period in 2008 when California first issued same-sex marriage licenses but who chose not to enroll their spouse and dependent children. The one-time exception also applies to members who married a same-sex spouse in another state where same-sex marriage was legal prior to June 26, 2013.

Can a same-sex spouse and eligible dependent children be added to a CalPERS health plan?

CalPERS members have always had the ability to enroll a spouse into health care coverage. Because of the U.S. Supreme Court ruling on the Defense of Marriage Act (DOMA), we are offering same-sex couples married prior to the ruling the opportunity to enroll spouses now.

We are providing a one-time exception enrollment opportunity effective immediately and ending December 31, 2013, to give members the opportunity to enroll a same-sex spouse.

Members who were married in 2008 but who choose not to add their same-sex spouse during this one-time exception enrollment period will not be permitted to add such persons again until the annual Open Enrollment period, or another qualifying event such as a loss of coverage.

The enrollment parameters for all newly married couples is the same as it has been: A person may add a new spouse (regardless of gender) and eligible dependent children to his or her health plan within 60 days from their marriage date. The effective date will be the first day of the month following the receipt of all required documentation.

To whom does the one-time exception enrollment period apply?

The one-time exception enrollment period applies to employees and retirees who married a same-sex spouse in California or another state where same-sex marriage is legal prior to the June 26, 2013 DOMA ruling, and wish to enroll their spouse and eligible dependent children onto their CalPERS health plan.

When is the one-time exception enrollment period?

The one-time exception enrollment period is available immediately and ends on December 31, 2013.

What is the health coverage effective date?

A spouse and eligible children will be enrolled effective the first day of the month following the receipt of all required documentation.

What supporting documentation is required?

Active employees:
Complete and submit a Health Benefit Plan Enrollment (PDF, 65 KB) form along with a copy of the marriage certificate. The form should include the Social Security number of the new spouse and any eligible dependent children, date of birth, and gender of all new enrollees. Please provide a copy of the birth certificate for each eligible dependent child. A daytime telephone number should also be included.

Retirees:
Submit a written request to CalPERS to add the same-sex spouse, along with a copy of the marriage certificate. The request should include the Social Security number of the new spouse and any eligible dependent children, date of birth, gender, and Medicare card, if applicable, of all new enrollees. Please provide a copy of the birth certificate for each eligible dependent child. A daytime telephone number should also be included.

Where should members submit the enrollment request and supporting documentation?

Active employees:
Submit the completed paperwork and supporting documentation to the designated personnel office or health benefits officer.

Retirees:
Submit a written enrollment request and supporting documentation to:
CalPERS
Health Account Services
P.O. Box 942715
Sacramento, CA 94229-2715
Fax: (800) 959-6545

How long will it take to receive identification cards from the health plan?

An employee's or retiree's spouse and eligible dependents should receive identification cards in approximately 45 days. If they do not receive the identification cards, or need to obtain medical or prescription services before the cards arrive, please contact the health plan's member services department.

What if a person's same-sex spouse and children are already enrolled as a domestic partner on their health plan?

The employee or retiree will be required to submit a copy of their marriage certificate to their employer, or CalPERS if retired. The relationship status of the parties and eligible dependent children will be changed to the appropriate relationship status.

Can a person who marries a same-sex spouse in another state add their spouse and dependent children?

A valid same-sex marriage performed outside California is recognized by CalPERS, as with any other marriage. As a result, a person who validly marries a same-sex spouse outside California may enroll the spouse and eligible dependent children onto their health plan. Currently, Massachusetts, Connecticut, Iowa, Vermont, New Hampshire, New York, Maryland, Maine, Minnesota, Washington, Rhode Island, Delaware and the District of Columbia (Washington, D.C.) have legalized same-sex marriage.

Can a person add their same-sex spouse and dependent children to their dental plan?

Please contact your dental plan administrator. CalHR administers the State-sponsored dental plan, the Chancellor's Office administers the CSU dental plan and public agency dental plans vary by employer.

Are there tax implications to add my same-sex spouse to my health plan?

Please consult a tax consultant to determine the impact to your personal tax obligation.

Dated: 09-13-2013