Dependent verification

About dependent verification

Dependent verification helps make sure the PEBB Program covers only people who qualify. If you are not enrolled in Medicare Part A and Part B and you want to add dependents to your coverage, you must provide valid verification documents to show they are eligible before they can be enrolled under your coverage.

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

Use the list(s) below to determine which verification document(s) you need to submit with your enrollment form(s). If you submit a tax return, you may submit just one copy if it includes all dependents that require verification, such as your spouse and children. Submit the documents along with your enrollment form(s) within the PEBB Program's enrollment timelines. See required forms and timelines for employees, retirees, and Continuation Coverage.

To enroll a spouse

Provide a copy of (choose one):

  • Most recent year’s federal tax return filed jointly that lists the spouse (black out financial information)
  • Subscriber’s and spouse’s most recent year's federal tax return if filed separately (black out financial information)
  • 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, only the marriage certificate is required.

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

Include the Declaration of Tax Status form to enroll a nonqualified tax dependent.

Provide a copy of (choose one):

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

*If within two years of state-registered domestic partnership, or establishment of a legal union as defined in statute, only the certificate/card of state-registered domestic partnership or legal union is required.

Note: If you encounter delays in getting the marriage certificate within the time allowed, contact your personnel, payroll, or benefits office (employees) or the PEBB Program (retirees/continuation coverage) before your enrollment period ends.

To enroll children

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

Provide a copy of (choose one):

  • The most recent year’s federal tax return that includes the child(ren) as a dependent and listed as a son or daughter (black out financial information)
    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 insurance coverage.