All Employees adding coverage or adding dependents will need to provide proof of eligibility for each dependent covered. Below is a list of acceptable documents that will need to be attached to the enrollment form.

Dependent / Eligibility Requirements / Acceptable Supporting Documentation
Spouse / Your legal spouse, unless legally separated / One of the following documents:
  • Copy of presently valid legal or religious marriage certificate, which must include the date of marriage.

Domestic Partner / Qualified domestic partner:
  • Two individuals who live together in a long-term relationship of indefinite duration. There must be an exclusive mutual commitment similar to that of marriage, in which the partners agree to be financially responsible for each other’s welfare and share financial obligations.
Please see NMSU Policy 7.04 manual for more information. / Submit the following set of documents:
  • Notarized Affidavit of Domestic PartnershipAND
  • A presently valid state-issued certificate, declaration or registration of civil union or common law union
ORthree of the following documents:
  • A joint mortgage or lease
  • Joint bank account
  • Joint credit account
  • Joint ownership of a motor vehicle.
  • Domestic partner named as beneficiary of the other’s retirement benefits.
  • Domestic partner named as beneficiary of the other’s life insurance
  • Domestic partner assigned durable property or health care power of attorney.
  • Shared household expenses ie: joint utilities statement, joint car, homeowners or renters insurance.

Child under age 26 / Your children until they reach age 26 which includes:
  • Biological children
  • Stepchild
  • Children placed in your home for adoption, or adopted children
  • Children for whom you have legal guardianship or court-ordered custody
  • Children for whom you have a Qualified Medical Child Support order
  • Biological or adopted children of a qualified domestic partner
/ Documentation must support the parental relationship:
Submit any one of the following documents:
  • Copy of the child’s legal or hospital birth certificate naming you, your spouse or your domestic partner as the child’s parent.
  • Copy of a final court order (divorce decree/custody agreement) naming you, your spouse or your domestic partner as the child’s parent. All documents must include the following information: names of the child and parent, official signature and/or court seal/stamp.
  • Copy of legal adoption papers issued by the courts naming you, your spouse or your domestic partner as the adoptive parent. All documents must include the following information: names of the child and parent, official signature and/or court seal/stamp.
  • Copy of legal guardianship/custody papers issued by the courts naming you, your spouse or your domestic partner as the child’s guardian. All documents must include the following information: names of the child and guardian, official signature and/or court seal/stamp.
  • Copy of a Qualified Medical Child Support Order (QMCSO) showing you are required to provide medical coverage for the child. Documentation must state your current employer’s name and include the names of the child and parent.
  • NEWBORNS ONLY (within 31 days of date of birth): Copy of hospital discharge papers or official hospital notification of birthwith the mother’s name and the baby’s name. If the birth mother is not covered on the NMSU benefits, then proof of marriage or domestic partnership will need to be provided to establish the mother’s relationship to the employee. A copy of the child’s birth certificate must also be provided, upon receipt, within 3 months of the child’s birth to continue coverage.
If you are an employee providing documentation for a child of your legal spouse or domestic partner, documentation must also include the required documentation listed for Spouse or Domestic Partner.
Child
age 26
and over / Any dependent disabled child, over the age of 26 who otherwise meets the criteria for “child” and is:
  • permanently disabled and not able to earn his or her own living because of a physical or mental disability which started prior to the date he or she reaches the maximum age for dependent children under the Plan
/ Documentation must support the dependent relationship and disabled status:
Submit the following set of documents:
  • Any one of the documents listed for Child to age 26.
AND the following document:
  • Physician statement certifying that the dependent child cannot support themselves because of a physical or mental disability prior to reaching the maximum age. All information must be pre-printed and dated within the last 12 months.
Note: Additional information or carrier specific form may be required by the benefit carrier to determine eligibility for benefits.

05-05-15