Section 599.855 - Dependent Verification and RE-Verification(a) For purposes of this section, "subscriber" means a state employee or state annuitant who is receiving state health benefits through enrollment in a health benefit plan provided by the California Public Employees' Retirement System.(b) For purposes of this section, "employing office" for state annuitants means the California Public Employees' Retirement System. For state employees, the employing office is the human resources division of the employee's appointing authority.(c) A subscriber's employing office shall obtain the following documents prior to enrollment and once every three years to verify the eligibility of a spouse or domestic partner to enroll or continue enrollment in a health benefit plan provided by the California Public Employees' Retirement System:(1) 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(2) Proof of current marital or domestic partnership status, as evidenced by either: (A) A copy of the first page of the subscriber's federal or state income tax return from the previous tax year listing the subscriber and the spouse or domestic partner; or(B) 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 subscriber 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.(d) A subscriber's employing office shall obtain the following documents prior to enrollment and once every three years to verify the eligibility of a subscriber's child to enroll or continue enrollment in a health benefit plan provided by the California Public Employees' Retirement System:(1) For a natural-born child, a copy of the birth certificate naming the subscriber as the parent.(2) For an adopted child, a copy of the adoption certificate naming the subscriber as the parent.(3) For a stepchild, a copy of the birth certificate naming the subscriber's current spouse as the parent.(4) For a domestic partner child, a copy of the birth certificate naming the subscriber's current domestic partner as the parent.(e) For children other than those listed in subdivision (d), for whom the subscriber has assumed a parent-child relationship, the subscriber's employing office shall obtain a copy of the documents described in section 599.500, subdivision (o)(1)(A) and (B) prior to enrollment and once every year to verify the child's eligibility to enroll or continue enrollment in a health benefit plan provided by the California Public Employees' Retirement System.(f) The employing office shall retain all documents received pursuant to subdivisions (c), (d), and (e) in the subscriber's official personnel file, or for state retirees the document history maintained by the California Public Employees' Retirement System, without a purge date. For subsequent re-verifications, the employing office is not required to request the documents provided pursuant to subdivisions (c)(1) and (d) if they are in the subscriber's official personnel file or document history maintained by the California Public Employees' Retirement System.(g) The employing office may request a subscriber to provide documentation at any time to substantiate a family member's eligibility for enrollment in a health benefit plan provided by the California Public Employees' Retirement System.(h) The California Public Employees' Retirement System shall send written notices to the subscriber at 90, 60, and 30 calendar days prior to the first of the month following the subscriber's birth month. The notices shall inform the subscriber of the requirement to submit documentation to their employing office to re-verify the eligibility of the subscriber's family members and specify the re-verification due date for any requested information. If the subscriber fails to provide adequate documentation prior to the re-verification due date, the subscriber's family members will be dis-enrolled from health coverage effective the first of the month after the re-verification due date. Subscribers desiring to dispute a termination must contact their employing office.(i) Within 30 calendar days of receiving documents as required under subdivisions (c), (d), (e), and (g) for re-verification, the employing office will review the documents and determine whether the documents support a family member's eligibility to continue enrollment in a health benefit plan provided by the California Public Employees' Retirement System. If the employing office determines that the documents do not support a family member's continued enrollment, the employing office shall inform the subscriber in writing and request documents that would support the family member's eligibility for continued enrollment in a health benefit plan provided by the California Public Employees' Retirement System.Cal. Code Regs. Tit. 2, § 599.855
1. New section filed 3-12-2018; operative 3-12-2018 pursuant to Government Code section 11343.4(b)(3) (Register 2018, No. 11). Note: Authority cited: Sections 18502, 19815.4 and 22843.1, Government Code. Reference: Section 22843.1, Government Code.
1. New section filed 3-12-2018; operative 3/12/2018 pursuant to Government Code section 11343.4(b)(3) (Register 2018, No. 11).