Dependent Eligibility Verification (DEV)

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) enrolled in 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 22959 authorizes 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 mylCalPERS will 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 the month 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 provide re- verification documents to their campus benefit office. Campus benefit offices are 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. ​The disenrollment process begins the first week of the birth month. 

Campus benefit offices are to keep all documents used in the DEV process in the employee benefit 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 916. 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 monitored in 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 DRV 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 in mylCalPERS and 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 license 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’s federal or state income tax return from the previous tax year listing the employee and 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 employee and 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 DEV cycle 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 DRV 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 license, 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 documents during the re-verification cycle?

If employees do not provide the required documents during their re-verification cycle, CalPERS will remove these dependents from health benefits effective the first of the month after the employee’s birth month. (However, the disenrollment process begins the first week of the 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 members are removed from health and/or dental benefits? 

CalPERS will mail a Cancellation Notice to employees 30 days prior to the first of the birth month if administratively removing their family members from health benefits. 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.    

Benefit offices 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 functionality to 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, Benefit offices are to inform employees in writing indicating the family members to be dis-enrolled and the effective date. Provide COBRA information to the family members within 14 days from their loss of coverage.

 

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

If employees provide re-verification documents for dis-enrolled, eligible dependents after the first day of the birth month but 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 that birth month.

If employees provide re-verification documents for dis-enrolled, eligible dependents after the birth month, benefit offices re-enroll the family members prospectively (first of the month following receipt of documents) 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’s re-verification cycle, CalPERS will administratively remove the child from health benefits upon the child turning age 26. The employee should inform the benefit 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 dependent due 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, the dependent should be removed due to the qualifying event rather than ineligibility found during the re-verification.

 

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

The CalPERS website 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 campus benefit office. 

 

Whom can employees contact if they disagree with the decisions from their campus benefit office on their dependent re-verification?

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

 

For question or inquiries please contact SF State Benefits Division at 415.405.4004 / benefits@sfsu.edu