Document Requirements
To understand which documents are required to prove dependent eligibility, please review each document listed next to the dependent(s) relationship on your Dependent Documentation Request mailed to you by Consova. The additional information below describes what documentation will be considered valid for the purpose of this verification.
Spouse
Plan Definition
- Your legally married spouse
Legally separated or divorced spouses are not eligible for coverage
Document Requirements
- Copy of marriage certificate
AND
-
A copy of page one through the signature line of your Jointly filed Federal Tax return from the most recent Tax season or both of your Tax returns if you file separately. Please black out the first five digits of any Social Security Numbers and any IRS Identity Protection PIN's.
AND
- The Benefit Verification and Information Release Authorization Form
Domestic Partner
Plan Definition
- Your eligible, unrelated, same or opposite sex domestic partner
Document Requirements
- Copy of the domestic partner affidavit (signed by you and your partner)
AND
- Proof of dependency as evidenced by a copy of two of the following documents:
- - Joint housing lease, mortgage, or deed at least 12 months prior to the date of the signed affidavit;
- - Joint ownership of motor vehicle;
- - Joint checking or savings account
- - Designation of the partner as a primary beneficiary of the team member's life insurance, retirement benefits or residuary estate under a will; or
- - Designation of the partner as holding a durable power of attorney for health care decisions regarding the employee
AND
- The Benefit Verification and Information Release Authorization Form
- Please note: Proof of dependency documents need to be dated within 60 days prior to the date of this letter and insurance and medical-related documents will not be accepted as a proof of dependency.
Child under the age of 26
Plan Definition
- - Your natural child, legally adopted child, or child in the process of being adopted
- - Stepchild;
- - Children of your enrolled Domestic Partner;
- - a foster child;
- - A child whom you have legal guardianship of; or
- - A child who is the subject of a Qualified Medical Child Support Order (QMCSO) issued to you
Document Requirements
- A copy of the following documents (varies by the relationship of the child to the Employee):
- - Natural child or legally adopted child: State or county issued birth certificate showing employee's name or signed court order.
- - Stepchild: State or county issued birth certificate showing parents' names, copy of your marriage certificate, and a copy of your federal tax return from the most recent tax season (front page only).
- - Child of your domestic partner: State or county issued birth certificate and proof of established Domestic Partnership
- - Child whom you have legal guardianship of: Signed Court Order and a copy of your federal tax return from the most recent tax season claiming the child as a dependent. Please be sure to leave the last four digits of the dependent’s SSN visible.
- - Foster child: Signed letter from social service agent confirming child has been placed under your care and your federal tax return from the most recent tax season claiming the child as a dependent.
- - A child who is the subject of a Qualified Medical Child Support Order (QMCSO): Signed Court Order.
Please note: for unmarried disabled children aged 26 or over, in addition to the birth certificate, we will also need a copy of your tax return from the most recent tax season claiming the child as a dependent (front page only).
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