Dependent verification

About dependent verification

Dependent verification helps make sure PEBB only covers people who qualify. If you are not enrolled in Medicare Part A and Part B and you want to add family members to your coverage, you must provide verification documents to show they're eligible.

You must submit all documents in English. Documents written in a foreign language must include a translated copy prepared by a professional translator and certified by a notary public.

Use the list below to determine which verification document(s) you need to submit with your enrollment form. Submit the documents along with your enrollment form(s) within PEBB's enrollment timelines. See required forms and timelines for employees, retirees, and COBRA/Continuation Coverage (formerly LWOP).

To enroll a spouse

Provide a copy of (choose one):

  • Most recent year’s 1040 Married Filing Jointly federal tax return that lists the spouse
  • Subscriber’s and spouse’s most recent 1040 Married Filing Separately federal tax return
  • Proof of common residence (example: a utility bill) and marriage certificate*
  • Proof of financial interdependency (example: a shared bank statement - black out financial information) and marriage certificate*
  • Petition for dissolution of marriage (divorce)
  • Legal separation notice
  • Defense Enrollment Eligibility Reporting System (DEERS) registration
  • Valid J-1 or J-2 visa issued by the U.S. Government

*If within two years of marriage or state-registered domestic partnership, only the marriage certificate or certificate/card of state-registered domestic partnership is required.

To enroll a state-registered domestic partner or legal union partner

Include the Declaration of Tax Status form to enroll a state-registered domestic partner or a state-registered domestic partner's child.

Provide a copy of (choose one):

  • Proof of common residence (example: a utility bill) and certificate/card of state-registered domestic partnership*
  • Proof of financial interdependency (example: a shared bank statement-black out financial information) and certificate/card of state-registered domestic partnership*
  • Petition for invalidity (annulment) of domestic partnership or legal union
  • Petition for dissolution of domestic partnership or legal union
  • Legal separation notice of domestic partnership or legal union
  • Valid J-1 or J-2 visa issued by the U.S. Government

*If within two years of marriage or state-registered domestic partnership, only the marriage certificate or certificate/card of state-registered domestic partnership is required.

To enroll children

Use the Extended Dependent Certification form to enroll an extended (legal) dependent child.

Provide a copy of (choose one):

  • Most recent year’s federal tax return that includes the child(ren) as a dependent and listed as a son or daughter
    Note: You can submit one copy of your tax return if it includes all family members that require verification.
  • Birth certificate (or hospital certificate with the child’s footprints on it) showing the name of the parent who is the subscriber, the subscriber’s spouse, or the subscriber’s state-registered domestic partner**
  • Certificate or decree of adoption
  • Court-ordered parenting plan
  • National Medical Support Notice
  • Defense Enrollment Eligibility Reporting System (DEERS) registration
  • Valid J-2 visa issued by U.S. Government

**If the dependent is the subscriber’s stepchild, the subscriber must also verify the spouse or state-registered domestic partner in order to enroll the child, even if not enrolling the spouse or state-registered domestic partner in PEBB coverage.