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Eligible Dependent Chart

Dependents Eligible for Coverage Required Documentation
Lawful Spouse A completed Dependent Enrollment Form pdf  and a certified copy of your marriage certificate.
Same-Sex Domestic Partner

All required documentation is outlined in the Same-Sex Domestic Partner Packet.

Dependent Children
up to age 26

A completed Dependent Enrollment Form pdf  and a copy of their birth certificate (if newborn a copy of the hospital birth record will suffice until you receive the official birth certificate).

Adoption/Guardianship A completed Dependent Enrollment Form pdf  and a copy of the adoption/release papers, guardianship or placement papers issued by a court of law.
Mental and Physical Handicapped
Dependents age 26 and older
A completed Dependent Enrollment Form pdf  and a completed Disability Applicationpdf  along with any other proof of incapacity including medical records and a statement of financial support.