Enrolling Family Members

Whether you cover yourself alone or include your family members in the CalPERS Health Program is up to you. But if you decide to cover your family members, you must cover all eligible family members as a single group.

Our guidelines for enrolling family members are as follows.

• Your spouse or domestic partner can be added to your health plan if done within 60 days after the date of your marriage or registration of your domestic partnership. A copy of your marriage certificate or Declaration of Domestic Partnership and your spouse's or domestic partner's Social Security number are required. (Review our  Enrolling Domestic Partners area for specific enrollment requirements.) Former spouses and former domestic partners are not eligible.

• Your children, adopted children, or stepchildren must be under age 23 and never married - regardless of whether or not they are living with you.

• A child over age 23, who has never married and is incapable of self support due to a mental or physical condition that existed prior to age 23, may be included when you first enroll. A Questionnaire for Disabled Dependent Benefit Form (HBD-98) and Medical Report for the CalPERS Disabled Dependent Benefit Form (HBD-34) must be approved by CalPERS prior to enrollment and must be updated upon request.

• Another person's child under age 23 who has never married may be eligible for coverage if you have been granted custody or joint custody by a court or the child resides with you. An Affidavit of Eligibility of Economically-Dependent Children Form (HBD-35) must be filed prior to enrollment and must be updated upon request.

You can add the following family members either at the time of enrollment or at a later date:

• A spouse or registered domestic partner not living in your home
• Children age 18 or older
• Eligible children who are not in your custody
• Dependents in the military, when they return to civilian life

Split Enrollments
Members who are married or in a registered domestic partnership who both work, or worked, for agencies in the CalPERS Health Program can enroll separately. If you and your spouse or domestic partner enroll separately, you must enroll all eligible family members, regardless of the relationship, under only one of you. Dependents cannot be split between parents.

For example, if a CalPERS member with children marries or registers a domestic partnership with another CalPERS member with children and each member has their own enrollment in the CalPERS Health Program, all children must be enrolled under one parent.

The effective date of coverage will be the first of the month following the date of marriage or domestic partnership registration. If split enrollments are discovered, they will be retroactively corrected. You will be responsible for all costs incurred from the date the split enrollment began.

Dual Coverage
You cannot be enrolled in a CalPERS health plan as a member and a dependent or as a dependent on two enrollments. This is called dual coverage and it is against the law. When dual coverage is discovered, the coverage will be retroactively canceled. You may have to pay for all costs incurred from the date the dual coverage began.

Family Changes

Divorce or Termination of Domestic Partnership
If you divorce or terminate a domestic partnership and your former spouse/former domestic partner does not work for a CalPERS health covered employer, your former spouse/former domestic partner is no longer eligible, even if the court orders you to provide health coverage for them. The coverage terminates on the first day of the month in which the final decree of divorce is granted. Former spouses may be eligible for coverage under a COBRA or an Individual Conversion Policy. You must submit a copy of your final divorce decree or Notice of Termination of Domestic Partnership form to your Personnel Office (if active) or CalPERS (if retired).

Newborn or Newly Adopted Child
Your newborn child is covered from the date of birth. Adopted children are covered beginning the date formal adoption takes effect.

Death of a Member
In the event of a retired member's death, please report this information by contacting us at 888 CalPERS (or 888-225-7377). If the member was still employed, contact the member's employer.

Surviving family members may be eligible for health coverage, as long as they:

• Qualify for a monthly survivor check from CalPERS
• Were enrolled or were eligible to enroll as dependents at the time of the member's death
• Continue to qualify as eligible family members

Death of an Active State Employee Only
Upon the death of an active State employee, the law requires their employer to continue to pay contributions for the survivor's health coverage for up to 120 days after their death.

Surviving family members will be eligible for health coverage as long as they:

• Qualify for a monthly survivor check from CalPERS
• Were eligible dependents at the time of the member's death
• Continue to qualify as eligible family members

This law applies to participating bargaining units. Contact the Department of Personnel Administration for participating bargaining units and instructions. If you find you are no longer eligible for the CalPERS Health Program, you may be eligible for COBRA.

Death of a Dependent
If you have lost a family member and they are a dependant under your health plan, notify your employer (or CalPERS if you are retired) as soon as possible.

Additional Resources
Enrolling Domestic Partners

Dated: 08-14-2009