July 27, 2023
Circular Letter: 600-038-23
Topic: Health Benefits

To: All CalPERS Health Benefits Officers and Assistant Health Benefits Officers


The purpose of this Circular Letter is to inform you of updates to the Disabled Dependent Member Questionnaire and Medical Report (HBD-34) (PDF) form and recertification timeframes effective April 2023. These changes are in addition to changes and responsibilities referenced in Circular Letter 600-016-22 (PDF).


A child incapable of self-support can retain eligibility for CalPERS health benefits as a dependent (i.e., not capable of engaging in any substantial gainful activity) due to physical or mental disability which existed continuously prior to becoming 26 years of age if they meet eligibility requirements. Upon certification of eligibility, the dependent’s CalPERS health and dental coverage must be continuous and without lapse.

Upon expiration of the certification, an updated HBD-34 and Authorization to Disclose Protected Health Information (PERS-BSD-35) (PDF) forms must be submitted for recertification. These documents must be received no earlier than 90 days prior to the expiration date, and no later than the expiration date.

New HBD-34 Form

The HBD-34 form has been updated to reflect changes to Section C: Medical Certification of Disability and Incapacity of Self-Support, which must be completed by a physician specializing in the dependent’s disability.

If a dependent is approved to retain eligibility for CalPERS health benefits, CalPERS will determine a dependent’s recertification timeframe based on the physician’s examination and the certification provided in Section C on the HBD-34.

The table below outlines recertification timeframes based on the option selected by the licensed physician:

Table Outlining Recertification Timelines Based On Physician Certification
Physician Certification Recertification Timeframe (i.e., Expiration Date)
Does not have physical or mental disability Not eligible for CalPERS health benefits
Medical Improvement is Expected Physician indicates recertification date (Less than 3 years)
Medical Improvement is Possible Maximum 3 years
Medical Improvement Not Expected Maximum 7 years

The new HBD-34 form is available to download from the CalPERS website. The HBD-34 has a revision date of April 2023. CalPERS will continue to accept the older version of the HBD-34 form through October 31, 2023.

Additional Resources

We encourage you to review the following guides for more information regarding the Disabled Dependent Process


If you have questions, call the CalPERS Customer Contact Center at 888 CalPERS (or 888-225-7377 888-225-7377).


Yesenia Croft, Chief
Health Account Management Division