Dependent Eligibility Verification
Dependent Eligibility Verification (DEV) is the process of verifying the eligibility of dependents enrolled in state health and dental benefits.
In June 2015, SB 98 was passed creating Government Code 22843.1, which requires State and CSU employers to:
- Verify the eligibility of all employees' dependents prior to enrolling them in a health plan.
- Retain and maintain a record of the verifying documentation for each dependent.
- Validate/re-verify dependent eligibility at least once every three years for most dependents.
Eligibility will be re-verified once every three years. The re-verification cycle is based on birth month. The following chart illustrates the schedule
|Year of Verification||2021||2022||2023|
Subscriber Birth Month
This three-year cycle repeats. If dependent(s) are enrolled within six months of the employee's birth month, their eligibility will be re-verified during the next cycle.
Recurring dependent re-verification is required for:
- Registered domestic partners
- Natural born children
- Adopted children
- Children of registered domestic partners
Note: The Dependent Re-verification doesn't include disabled dependent(s) or a parent-child relationship dependent(s) who are enrolled in employer-sponsored health and/or dental coverage. Disabled dependent(s) and parent-child relationship dependent(s) have a separate re-verification process.
CalPERS will mail letters to each employee based on the employee's birth month. Employees with at least one dependent will receive up to three notification letters.
|Initial Notice||90 days prior to the 1st of the employee's birth month||The notice provides information to employees on their upcoming verification date and the names of the dependents for whom documents must be submitted to verify their continued eligibility. Employees are instructed to submit the required documents to their employer's personnel office. The notice informs employees about potential monies owed and gap in coverage if documents are not submitted timely.|
|Reminder Notice||60 days prior to the 1st of the employee’s birth month||The notice reminds employees to submit verification documents for their dependents to their employers. The notice informs employees about potential monies owed and gap in coverage if documents are not submitted timely.|
|Deletion Notice||30 days prior to the 1st of the employee’s birth month||The notice informs employees of which dependents were not verified and the date they will be deleted. This notice directs them to their employer for additional questions on verifying their dependents. The notice informs employees about potential monies owed and gap in coverage if documents are not submitted timely.|
Notification letters will be mailed to the employee's mailing address on file in the myCalPERS system. Employees must provide the required documentation to their employers prior to the final filing date indicated on the letter. If documentation is not provided to the employer by the final filing date, the employee's dependent(s) will be removed automatically from the employee's health coverage.
We'll inform the employee the month before their birth month in writing if we administratively remove their dependent(s) from health benefits. Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation of coverage information will be included with the letter. Dependent’s disenrollment takes effect the first of the month after the employee’s birth month. If the employee provides verification documents for disenrolled eligible dependents after the verification due date, employer must verify and reenroll the dependent’s prospectively for health benefits. This will result in a gap of benefit coverage.
If you’d like to review DEV letters, select the appropriate one below:
A copy of a government issued marriage certificate AND one of the following documents:
- A copy of the first page of the most recent federal or state tax return confirming the dependent as your spouse.
- 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 other documents that substantiate the existence of a current marriage. Household bills and account statements older than 60 calendar days are unacceptable.
Note: The first document establishes the life event allowing the enrollment of the dependent (i.e., marriage or registering as domestic partners). The second document substantiates the relationship is current.
A copy of the Declaration of Domestic Partnership registered with the California Secretary of State or a comparable agency in another jurisdiction and one of the following documents:
- A copy of the first page of the most recent federal or state tax return confirming the dependent as your 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 domestic partner, or other documents that substantiate the existence of a current domestic partnership. Household bills and account statements older than 60 calendar days are unacceptable.
One of the following documents:
- A copy of the child's birth certificate or adoption certificate naming the employee, spouse, or domestic partner as the parent of the child.
*For a stepchild or domestic partner's child, the employee must also provide documentation demonstrating the relationship to the employee's spouse or domestic partner, as requested above.
Health Benefits Officer Role
Procedures outlining the Dependent Enrollment Verification process are available in the student guides section of our website.
Reason CodesTo facilitate this re-verification process, we added the following health reason codes in myCalPERS in December 2017.
|Reason Number||Reason Name||Description|
|916||Verification of Dependent||HBOs should use this code to verify dependent(s) when all documentation has been received before the deletion effective date.|
|220||Re-enrollment of Verified Dependent||HBOs should use this code to re-verify and re-enroll a dependent(s) after a batch or online Delete Dependent - Did Not Verify health event has been processed.|
|331||Delete Dependent - Did Not Verify - Online||HBOs can use this code to preemptively delete dependents who were not verified during the recertification process. However, if HBOs do not process a deletion, the system will automatically process a deletion batch if a dependent is not verified.|
|854||Delete Dependent - Did Not Verify - Batch||HBOs cannot use this code when an employee fails to verify their dependent. It is an automated deletion batch in myCalPERS.|
The following three reports are available in myCalPERS to identify the employees who are part of each verification process:
- Dependent Verification End Date Employer Report - HBOs can use this report to get a list of the employees’ dependent(s) by the selected verification end date.
- Dependent Verification Health Event Employer Report – HBOs can use this report to get a list of dependent(s) that have been deleted with the Delete Dependent – Did Not Verify health event and/or a list of dependent(s) that were verified with the Verify Dependent – Verification of Dependent health event.
- Dependent Verification Dependents with Past Due or No End Date Active Health Report – HBOs can use this report to identify any dependent(s) that remain enrolled despite their certification being either past due or missing.
Frequently Asked Questions
The State Employee and Employer Frequently Asked Questions are available online at FAQs for State Employees and FAQs for State HR Offices. CSU versions are available online at FAQs for CSU Employees (DOCX) and FAQs for CSU HR Offices (DOCX).
Forms & Publications
- Certification of Medicare Status (PDF)
- Ineligibility of Medicare Certification (PDF)
- Medicare Enrollment Guide (PDF)
Frequently Asked Questions
- Can I continue my CalPERS Basic health plan coverage if I am Medicare eligible, retired from CalPERS, and returning to work?
You may continue your enrollment in a CalPERS Basic health plan if you receive your health coverage through employment status and not as a retiree through retirement status, or if you're eligible to defer your Medicare enrollment. You may be able to defer Medicare enrollment if you're Medicare eligible and covered by an employer group health plan (yours or your spouse's). If you defer enrollment, you'll be able to enroll during a Special Enrollment Period after either your employment or your employer group health coverage ends.
- How do I switch to a CalPERS Medicare health plan after retirement?
Sign up for Medicare Part B as soon as you qualify and read the Medicare Enrollment Guide (PDF) for more information.
- If I didn't pay the increased amount for my Medicare Part D insurance, what will happen to my CalPERS benefits?
Immediately contact the Social Security Administration to see if you can reinstate your Medicare Part D, either without a lapse in coverage or on a prospective basis. Medicare Part D is your prescription drug coverage, and if you have lost your Medicare Part D enrollment, you will pay out of pocket for your prescription drug coverage. If you enroll in a non-CalPERS Medicare Part D prescription drug plan, you will lose all of your CalPERS health coverage.
- If I don't want Part B benefits, will this affect my CalPERS Medicare health plan?
You must have Medicare Part B to participate in a CalPERS Medicare health plan. If you cancel or choose not to enroll in your Part B coverage, then you'll lose your CalPERS health coverage. If you don't sign up for Medicare Part B when you turn 65 and decide to sign up for it later, you may have to pay a federal Part B penalty surcharge. If you sign up later, you'll pay more for every month of your Part B coverage. Contact the Social Security Administration at (800) 772-1213 or TTY at (800) 325-0778 for more information about the Part B penalty surcharge.
- If I lost my CalPERS health benefits because I stopped my Part B insurance, how can I get them back?
Immediately contact the Social Security Administration (SSA) to see if you can reinstate your Medicare Part B, either without a lapse in coverage or on a prospective basis. If this isn't possible, you can only enroll during SSA's annual General Enrollment period with an effective date of the following July 1. Some SSA offices will process your request outside of the General Enrollment period, but your effective date will still be the following July 1. You may request re-enrollment in a CalPERS Medicare plan based on the effective date of your Medicare coverage.
- What are the optional benefits offered by UHC for contracting agencies?
UHC offers two health plan options for Medicare retirees from contracting agencies: a PPO plan with dental and vision, or a PPO plan without dental and vision. The dental and vision coverage is available to Medicare-eligible members not covered under their retirement benefits for an additional premium. For more information, see Optional Benefits for CalPERS Contracting Agencies.