What Is the Dependent Eligibility Verification?

Dependent Eligibility Verification FAQs

CSU Campus Benefit Offices

What is the Dependent Eligibility Verification?

The Dependent Eligibility Verification (DEV) is the process of re-verifying the eligibility of spouses, domestic partners, children, stepchildren, and domestic partner children (family members) enrolledin CalPERS health and CSU dental benefits. Government Code section 22843.1 mandates re-verifying the eligibility of these family members for health benefits. Government Code section 22959authorizes extending this review to family members enrolled for dental benefits.

When will the re-verification occur?

The eligibility of these family members will be re-verified once every three years. The re-verification period is based on the employee's birth month. The following chart illustrates the schedule:

Year of Re-verification
2018 / 2019 / 2020 / 2021 / 2022 / 2023
Employee
Birth
Month / April July October / February May
August November / March June September December / January* April
July October / February May
August
November / March June September December

This three-year cycle repeats. Employees enrolling family members within six months of their birth month will re-verify their eligibility at the next cycle. Example: An employee with the August birth month enrolls a spouse in May 2019. The eligibility of this spouse will be re-verified in 2022.

* The DEV function in mylCalPERSwill activate in February 2018. Employees with the January birth month will initially re-verify their family members in 2021.

How will employees know to re-verify their family members?

Ninety (90) calendar days before the first of themonth following the employee’s birth month (re-verification due date), CalPERS will send a letter to the employee providing the re-verification due date, and listing the enrolled family members for re-verification and the acceptable re-verification documents. Employees are to promptly providere- verification documents to their campus benefit office. Campus benefit officesare to re-verify the same family members for dental benefits, if enrolled.

Delay in re-verifying the eligibility of family members may result in their loss of health and/or dental coverage.

Campus benefit offices are to keep all documents used in the DEV process in the employeebenefit folder without a purge date.

What is the timeframe for campus benefit offices to review the re-verification documents?

Upon receiving the re-verification documents, benefit offices are to review them and determine if they support the continued enrollment of the family members. If they do, benefit offices are to key in PeopleSoft that the dependents are re-verified using Permitting Event Code 913.The PSR outbound interface will notify CalPERS to maintain dependent enrollment. CalPERS has these dependents set to terminate if campuses do not notify CalPERS via PSR that documents have been verified. If the documents do not support the continued enrollment of the family members, benefit offices are to inform the employees in writing (i.e., letter or email), that the documents are deficient and to provide documents that demonstrate a family member relationship. Employee health event changes can be monitoredin PeopleSoft and through created PeopleSoft queries. If CalPERS removes family members from health benefits, benefit offices are to remove the same dependents from medical and dental benefits in PeopleSoft.

How can benefit offices facilitate an efficient DEV process?

Functionality within PeopleSoft will assist benefit offices with tracking employees whose family members require re-verification. The“Dependent Verification End Date Report”is available inmylCalPERSand will provide dependent information for those to be re-verified. CalPERS reports can be used for auditing enrollments between PeopleSoft and CalPERS.

Will employees be required to provide original documents?

Employees should provide copies of the documents and write “Not for Official Use” on them.

What re-verification documents are required?

Dependent Type / Required Re-verification Documents
Spouse or Domestic Partner / A copy of the marriage certificate or domestic partnership registration filed with the California Secretary of State or a comparable agency in another jurisdiction listing the family member as the domestic partner.
AND
A copy of the first page of the employee’sfederal or state income tax return from the previous tax year listing the employeeand the spouse or domestic partner.
OR
A combination of other documentation, including but not limited to, a household bill, account statement, or insurance policy listing the name and address of the employeeand the spouse or domestic partner, or other documents that substantiate the existence of a current marriage or domestic partnership. Household bills and account statements older than 60 calendar days are unacceptable.
Natural-born Children / A copy of the birth certificate naming the employee as the parent.
Adopted Children / A copy of the birth certificate or adoption certificate naming the employee as the parent.
Stepchildren / A copy of the birth certificate naming the employee’s current spouse as the parent.
Domestic Partner Children / A copy of the birth certificate naming the employee’s current domestic partner as the parent.

Why are two documents required for re-verifying a spouse or domestic partner, instead of just the marriage certificate or the Declaration of Domestic Partnership?

The first document establishes the life event allowing the enrollment of the dependent (i.e., marriage or registering as domestic partners), while the second required document substantiates the relationship is current.

Will employees be reimbursed for the cost of obtaining re-verification documents?

Employees will be responsible for any charge related to obtaining copies of the required documents.

Why are employees required to provide the documents again, when they were provided when the dependents were initially enrolled?

Providing a copy of the documents for the initial DEVcycle will enable a more direct process for the benefit offices to re-verify the family members. Benefit offices are to keep all documents used in the DEV process in the employee benefit folder without a purge date. In subsequent re-verifications, employees need to provide the required documentation that substantiates the relationship is current.

They do not need to provide the marriage certificate, domestic partnership registration, and birth certificates for stepchildren or domestic partner children if the marriage or domestic partnership remains current. Employees do not need to provide birth certificates for natural-born children or adoption certificates for adopted children again.

What about the documents that employees provided to HMS Employer Solutions (HMS) during the Dependent Eligibility Verification (DEV) project in 2013 and 2014?

HMS securely destroyed the documents received during the DEV project to protect the privacy of employees and their family members.

What happens if employees do not provide the required documentsduring the

re-verification cycle?

If employees do not provide the required documents during their re-verification cycle, CalPERS will removethese dependentsfrom health benefits effective the first of the month after the employee’s birth month. Benefit offices must cancel medical and dental coverage for these dependents in PeopleSoft to track with the cancellation in MyCalPERS.

How will employees know if their family membersare removed from health and/or dental benefits?

CalPERS will mail a Cancellation Notice to employees30 days prior to the first of the employee’s birth month. The notice informs employees which dependents were not verified and the date on which they will be deleted. CalPERS will include Consolidated Omnibus Budget Reconciliation Act(COBRA) continuation of coverage information with this letter.

Benefitoffices are to inform employees in writing,within 14 days from their dependent deletion,explaining the same family members are removed from dental benefits and the effective date, if enrolled.Include COBRA information with this letter.

What about family members enrolled for dental benefits only?

Benefit offices are to use PeopleSoft functionalityto track employees with family members enrolled for dental benefits only, and re-verify their eligibility for continued coverage once every three years, following the DEV schedule.

When removing ineligible family members enrolled for dental benefits only, Benefitoffices are to inform employees in writing indicating the family members to be dis-enrolled and the effective date. Provide COBRA information to the family memberswithin 14 days from their loss of coverage.

What happens if employees provide re-verification documents after the family members aredis-enrolled from benefits?

If employees provide re-verification documents for dis-enrolled, eligible dependents after the first day of the birth monthbut before the last day of the birth month, benefit offices may rescind the dependent deletion by using Permitting Event Code 913. This may result in an accounts receivable for the employee depending on timing of when the employee provides the re-verification documents in the birth month.

If employees provide re-verification documentsfor dis-enrolled, eligible dependents after the birth month, benefit offices re-enroll the family members prospectively for health and/or dental benefits using the “Add Dependent—Re-enrollment of Verified Dependent” Permitting Event Code 220. This will result in a lapse of benefit coverage.COBRA continuation of coverage is an option for dependents during the lapse in coverage.

ENROLLMENT SCENARIOS

If an enrolled child turns 26 during the re-verification period, how should the employee proceed?

If the child's 26th birthdate coincides with the employee’sre-verification cycle, CalPERS will administratively remove the child from health benefits upon the child turning age 26. The employee should inform thebenefit office to remove the child from dental benefits, if enrolled.

During an employee’s re-verification cycle, one of the dependents obtained non-CalPERS sponsored health coverage. Can the employee remove the dependent from the CalPERS health plan?

Employees should contact their benefit office immediately if they wish to remove a dependentdue to a “permissive qualifying event” (e.g., family member obtains non-CalPERS sponsored health benefits, family member enters military, custody change for child under age 18, or child reaches age 18).The dependent should be removed due to a qualifying permissive event rather than ineligibility found during the re-verification process.

How should the employee respond if during the re-verification cycle, the employee receives a notice from CalPERS to recertify a parent-child relationship (PCR) dependent or a disabled child age 26 and over?

Benefit offices will utilize PeopleSoft functionality to recertify a PCR dependent or a disabled child age 26 and over. If the dependent relationship is not designated correctly in PeopleSoft as PCR, the Annual verification will not be sent in the PSR interface and the dependent coverage could be cancelled.

An employee needs to remove a dependent due to a qualifying event and receives a Dependent Re-Verification notice. How should the employee proceed?

Employees should notify their benefit office immediately of any qualifying event that occurs during the re-verification period, such as divorce or termination of domestic partnership. In these situations, thedependent should be removed due to the qualifying event rather than ineligibility found during the re-verification.

Are COBRA enrollees included in the DEV?

No, COBRA enrollees are not included in the DEV process. There may be timing issues if the enrollment in COBRA coverage is within 90 days of the employee’s birth month in a re-verification year (e.g., October 2018). Refer to the Dependent Verification End Date Report in MyCalPERS for a listing of the employee’s dependent(s) to be verified.

Where can employees and benefit office staff find more information on health and dental benefits?

TheCalPERSwebsite contains health benefit information. The CSYou’s Intranet site at csyou.calstate.edu contains dental benefit information.

Whom can employees contact with additional questions?

Employees can contact their campusbenefitoffice.

Whom can employees contact ifthey disagree with the decisions from their campus benefit officeon their dependent re-verification?

Campus benefit offices can contact the Systemwide Benefit Office on behalf of the employee. See contact information below.

Systemwide Benefit Representative

CSU, Office of the Chancellor

562-951-4411

June 20181