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 plans.

Spouse/Registered Domestic Partner

• As of January 1, 2020, persons of the same gender or opposite above the age of 18 may enter into a domestic partnership through the California Secretary of State.
• Required documents for spouse or domestic partner (all documents are required):
  • Marriage Certificate/ State Declaration of Domestic Partnership 

  • Social Security Card 

     

Children

• Natural, adopted or stepchildren

  • Children under age 26 are eligible regardless of whether or not they are living with the employee, married, or eligible for alternative coverage.
  • Required documents for children (both documents are required):
    • Birth certificate(s)/VOB (Verification of Birth for newborns or adoption documents
    • Social Security Card(s)

Children

• Children other than the employee's natural, adopted or step-child

  • Children who are 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 (all four documents are required):
    • 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 the employee’s mailing address.

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

Children

• Children with a disability 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

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