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 3 documents are required):
  • 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

  • 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)/temporary hospital records 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 4 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 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.

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.