Employee Health & Welfare Benefits

Important:  Dependent Verification
The District requires employees who enroll dependents in their medical, dental and/or vision insurance plans to provide documents to verify their dependents' eligibility for coverage.

Your enrollment form must be accompanied with supporting documentation for your dependents.

Legally married spouse as defined by State law

• Marriage License
• A signed copy of your your most recent Federal Tax Return of employee and spouse (blackout financial information) will also be accepted if marriage license is unavailable.

• California Certificate of Domestic Partnership; or
• Completed Domestic Partnership Affidavit

• Government-issued Birth Certificate reflecting that the child is the employee's or spouse's child; or
• Most recent copy of tax return with signature of Employee/Spouse listing child as dependent (blackout financial information)

• Government-issued Birth Certificate reflecting that the child is the spouse's child, AND Marriage License; or
• Government-issued Birth Certificate reflecting that the child is the spouse's child, AND signed copy of tax return of employee and spouse (blackout financial information)

• Government-issued Adoption Order, AND government issued Birth Certificate, or
• Foreign adoption approved by the INS or legal adoption documents from foreign country AND home government issued Birth Certificate

Guardianship Child

• Court Order of Legal Guardianship, AND first page of Federal Tax Return (blackout financial information). Excludes temporary guardianship orders.

Disabled Child

• Notice of disability determination from medical carrier prior to attaining age 26 AND child documentation (biological/step/adopted/guardianship), or
• Notice of disability determination from the Social Security Administration prior to attaining age 26 AND child documentation (biological/step/adopted/guardianship)