Eligible Dependents

Eligible employees may enroll themselves only, or enroll themselves and all eligible dependents (who are not otherwise enrolled as an employee, annuitant or dependent under the Public Employees' Medical and Hospital Care Act-PEMHCA).

The following family members are benefit eligible under the employee's plan:

  • Spouse
  • Registered Domestic Partner
    • Same gender if both partners are over the age of 18
    • Opposite gender if at least one partner is over the age of 62
  • Required documents for spouse or domestic partner:
    • Marriage Certificate/Declaration of Domestic Partnership
    • Social Security Card
    • Proof of Residency (i.e. utility bill within the last 60 days or front page of the most recent year income tax return showing the same address as the employee)
  • Children (Natural, adopted or stepchildren under age 26 are eligible regardless of whether or not they are be living with the employee, married or eligible for alternative coverage).
  • Required documents for children:
    • Birth certificate(s)/temporary hospital records for newborns or adoption documents
    • Social Security Card(s)
  • Children (a child other than the employee's natural, adopted or step-child, who is living with the employee in a parent-child relationship and of whom the employee has been granted custody or joint custody.
  • Required documents for children in a Parent-Child Relationship:
    • Affidavit of Parent-Child Relationship
    • Birth Certificate(s)
    • Social Security Card(s)
    • Most recent income tax return or court order naming the employee/spouse as legal guardian, and/or daycare receipts/school records indicating residence at employees’ mailing address.

Note: Employee must submit the Affidavit and tax return annually thereafter up to age 26. HR Benefits will approve/deny each affidavit.

  • Disabled children over age 26
  • Required documents for disabled children over age 26:
    • Medicare Card
    • Member Questionnaire for the CalPERS Disabled Dependent Health Benefit form
    • Medical Report for the CalPERS Disabled Dependent Benefit form

NoteEmployee must submit the documents listed above to CalPERS directly for approval prior to the enrollment and they must be updated upon request.