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 Documentation Checklist 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
- -Legal Spouse or common law spouse
Legally separated or divorced spouses are not eligible for coverage
Document Requirements
- Copy of marriage certificate or Declaration of Informal Marriage
AND
-
A copy of page one through the signature line of your Jointly filed Federal Tax return from the most recent Tax season. Please black out the first five digits of any Social Security Numbers and any IRS Identity Protection PIN's. You can obtain your Tax Return transcript from the IRS by mail, by going online to irs.gov or by calling 1-800-908-9946. Note: If your spouse files married separately, head of household or single, you will also need to submit their Tax Return from the most recent Tax season. Please black out the first five digits of any Social Security Numbers and any IRS Identity Protection PIN's.
AND
- Spousal Surcharge Verification and Information Release Authorization Form
Domestic Partner
Plan Definition
- -Your eligible, unrelated same-sex or opposite-sex domestic partner.
Document Requirements
- Proof of dependency as evidenced by a copy of two of the following documents:
- - Proof of shared residence via joint mortgage statement or rental agreement
- - Automobile title or registration showing joint ownership of vehicle
- - Joint checking, bank or investment account statement
- - A will and/or life insurance policy which designates the other as primary beneficiary
- - A durable property of health care power of attorney
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.
Children age 26 and under
Plan Definition
- - Your natural child, legally adopted child, or child in the process of being adopted;
- - Stepchild;
- - Your unmarried grandchild, whose parent is also covered on the medical plan, and the grandchild lives with you and is a dependent for tax purposes;
- - An unmarried child under age 18 for whom you, the employee, are the court appointed legal guardian, and the child lives with you and is a dependent for tax purposes; or
- - A child who is the subject of a Qualified Medical Child Support Order (QMCSO) or court order indicating you have to provide health care
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 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 copy of your joint federal tax return from most recent tax season.
- - Grandchild whose parent is also enrolled on the medical plan: State or county issued birth certificate and tax return from the most recent tax season claiming this child as a dependent.
- - Child whom you have legal guardianship who is under the age 18: Signed Court Order and your 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) or court order indicating you have to provide health care: Signed Court Order IF no current QMCSO/Court Order on file.
Please note: for unmarried disabled children aged 26 or over, in addition to the birth certificate, we will also need a copy of your federal tax return from the most recent tax season claiming the child (front page only).
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