[May 9, 2006]

Family Member Verification

• What is the family member verification audit?  Who participates in the audit? 
  On an annual basis, UC HR/Benefits will randomly select a percentage of all members, employees and retirees, enrolled in UC-sponsored health plans and require them to provide documentation to verify each of their dependent(s) enrolled in health and welfare plans. Examples of documentation include marriage or birth certificates, verification of same-sex domestic partnerships, adoption records, and tax records. 

• Why does UC need to conduct this audit?
  The University incurs significant costs to provide group insurance coverage for employees and their family members. This audit, which is required by UC Group Insurance Regulations, helps UC control costs by ensuring that family members enrolled in health and welfare plans are fully eligible for coverage.

• When does the audit occur?
  The annual audit begins in May of each year.

• Is my common-law spouse eligible for benefits?
  California does not recognize common-law marriages, however University Group Insurance Regulations do recognize common-law marriages established in states outside of California that honor this type of union. The employee has the burden to prove that a common-law marriage was established in a state that recognizes them. For additional questions about what evidence to use to establish that there was common law marriage, the employee should contact the state or seek the assistance of a lawyer.

STATES THAT RECOGNIZE COMMON LAW MARRIAGE:
Alabama
Colorado
Georgia (if created before 1/1/97)
Idaho (if created before 1/1/96)
Iowa
Kansas
Montana
Ohio (if created before 10/10/91)
Oklahoma (possibly only if created before 11/1/98)
Pennsylvania (if created before 9/03)
Rhode Island
South Carolina
Texas
Utah
Washington, D.C

• Does UC recognize family members of "common-law" marriage for UC-sponsored coverage?
  The child of a common-law marriage is eligible for benefits if a birth certificate is provided as verification demonstrating that the dependent is a natural child of an eligible UC employee. Or in the case of an adopted child, adoption papers signed and sealed by a court of law are required.  

• Does UC recognize a marriage license obtained from a country outside of the United States for UC-sponsored coverage?
  Yes. If the marriage license is in a language other than English, please obtain a translation and provide both documents.

• What verification is needed for a domestic partner?
  For opposite-sex domestic partners, where one partner is at least age 62 and eligible to receive Social Security benefits based on age, and for same-sex domestic partners, the couple must provide:

• • A copy of the California Declaration of Domestic partnership filed with the Secretary of State

• If the partnership is not registered with the state, the couple must complete the UC Declaration of Domestic Partnership form and provide any three of the following:

• • Joint mortgage or joint tenancy on a residential lease

• • Joint bank account

• • Joint liabilities (for example, credit cards or car loans)

• • Joint ownership of significant property (for example, a car or house)

• • Durable property or health care powers of attorney

• • Wills, life insurance policies, or retirement annuities naming each other as primary beneficiary

• • Written agreements or contracts regarding the relationship showing mutual support obligations or joint ownership of assets acquired during the relationship.

• • Copy of any declaration affidavit or similar document files with any other government entity

• Is a passport appropriate documentation if I immigrated to the US to verify spouse, child?
  No, the Group Insurance Regulations require a copy of a marriage certificate or birth certificate. If these documents cannot be obtained, employees should contact Office of the President to discuss further arrangements on a case by case basis.

• Why can't I just submit my tax return, which shows all my dependents?

• • A tax return cannot be used to verify a natural child, spouse, domestic partner.   The tax return can be used along with other documents to verify adult dependent relative, grandchild, stepchild, legal ward, disabled child.

• • In addition, the UC Office of General Counsel and the Benefits Administration group have determined specific, acceptable documentation for the verification of family members. Documentation may include but is not limited to:

• • • Marriage certificate,

• • • Birth certificate

• • • Adoption papers

• • • California State Registry form (refer to Your Group Insurance Plans for alternative documents)

• If I'm asked to provide verification for my common-law spouse, can we marry and provide a marriage certificate during the audit?  When would my new spouse be eligible for benefits?
  No, your newly acquired marriage certificate cannot be used for the verification of a past ineligible relationship. You and your family members will be de-enrolled for a period of 12-months and will be given the option to continue coverage at your own expense.   Your circumstance may need to be reviewed individually; please contact the Customer Service Call Center 1-800-888-8267.

• What documentation is needed to verify an adopted child?  What about an adopted child from a foreign country?
  Documents signed and sealed by a court of law are required for the verification of an adopted child.

• For parents with 50/50 custody of children and stepchildren, when are they eligible for benefits?   What documentation is required to verify eligibility?

• • A birth certificate is required to verify eligibility of a natural child of an employee of the University.

• • For stepchildren, the employee of the University must produce a copy of the most recent year's tax return showing the stepchild as a dependent. If the stepchild is not claimed as a dependent by the University employee, they are not an eligible dependent.

• Can I cover my natural or adopted children in UC-sponsored coverage who do not qualify as tax dependents under IRS rules?
  Yes, for a natural child under the age of 23, a birth certificate is the required document to verify eligibility. For an adopted child under the age of 23, please provide adoption documents signed and sealed by a court of law.

• What if I get married during the audit?
  If your spouse is reflected on your audit statement, then you must provide a marriage certificate dated from the time of enrollment in coverage to verify eligibility.

• If I cancel coverage for any of my dependents, during the audit do I still need to provide documentation?
  Yes, documentation is still required to verify their eligibility for benefits.

• When will the de-enrollment occur?
  If you and your family members are de-enrolled, it will be effective November 1.

• Will my de-enrolled family member be eligible for COBRA?
  Yes, you and your eligible family members would be provided with the opportunity to enroll at your expense in a COBRA-like coverage for the 12-month de-enrollment period. Your ineligible family members would be permanently de-enrolled.

• When would my de-enrolled family members be eligible for benefits?
  You and your eligible family members would be eligible again after 12 months. When your 12-month de-enrollment period ends, you are given a 31-day Period of Initial Eligibility to enroll in any plan for which you are eligible. Please see Your Group Insurance Plans (YGIP) regarding PIE rules.

• If I'm de-enrolled, what should I do if I receive Open Enrollment materials?
  During your 12-month de-enrollment period, you may not re-enroll yourself or your family members as part of Open Enrollment, so you should ignore Open Enrollment information about any plans from which you are de-enrolled. 

• If I'm de-enrolled but later provide documentation to verify family members, when am I eligible for benefits again?
  If you are de-enrolled, but later provide documentation, you and your family members will be re-enrolled effective the first of the month following the date documentation is received.¹

¹ The effective date on a re-enrollment must be the 1^st of the month following the receipt of documentation to be in alignment with our contractual agreement of no partial month coverage.

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