Dependent Eligibility

Definitions and

Required Documents

Are you enrolling a spouse, domestic partner or child in health care, dental or vision coverage? If so, the County of Orange requires that you provide the documents described below. Spouse Domestic Partner

Eligibility Definition

Individual to whom you are legally married

Required Documents

If married less than six months:

• Marriage certificate

If married more than six months:

• Marriage certificate, and

• Federal tax return issued within last year listing spouse, or proof of joint financial arrangement such as any of the following documents with both names at the same address

(black out all financial information)

o Mortgage Statement within 6 months

o Bank Statement within 6 months

o Active Lease Agreement (Must show lease begin and termination date) o Credit Card Statement within 6 months

o Property Tax Statement within 6 months

o State Tax Return, current tax year

o Mortgage Interest Statement (1098) within 12 months o Homeowners Insurance Statement within 12 months

o Renters Insurance Statement within 12 months

o Auto Loan Statement within 6 months

Eligibility Definition

Opposite-sex or same-sex individual to whom you are legally registered as a domestic partner

Required Documents

If partnership was registered less than six months ago:

• Certificate of domestic partnership registration If partnership was registered more than six months ago:

• Certificate of domestic partnership registration, and

• State tax return issued within last year listing partner, or proof of joint financial arrangement issued within last six months such as joint bank account, joint loan or billings in both names at the same address

(black out all financial information)

You are not required to obtain a certificate of domestic partnership from your current place of residence. You may obtain a government-issued certificate from any municipality, county or state that issues one. Children

Eligibility Definition

Children under age 26, including:

• Stepchildren

• Foster children

• Children placed for adoption

• Legally adopted children

• Children of a domestic partner

Children age 26 or over who are:

• Medically certified as disabled1, and

• Financially supported by you and/or your spouse/domestic partner

“Children” does not include any legally married spouse or domestic partner, or children of your dependent child (i.e., your grandchildren). Required Documents

Biological children:

• Birth certificate

Stepchildren:

• Birth certificate, and

• Parents’ marriage certificate (if married less than six months) OR parents’ marriage certificate plus federal tax return or other proof of joint financial arrangement (if married more than six months)2

Children of a domestic partner:

• Birth certificate, and

• Parents’ certificate of domestic partnership registration (if partnership registered less than six months ago) OR certificate of domestic partnership registration plus state tax return or other proof of joint financial arrangement (if partnership registered more than six months ago) 2 Children for whom you have legal guardianship, adopted children or foster children:

• Government-issued legal document proving relationship such as: adoption certificate, final court order, adoption decree with judge’s signature and seal, court-ordered adoption placement agreement, court-ordered document of legal guardianship, or foster care placement letter

• Document must include child’s name, child’s date of birth and your name. For disabled children, also include:3

• Front page of federal tax return issued within last year claiming the disabled child as a dependent (black out financial information), and

• Indicate if the child has a Social Security disability award or if one is pending 1Disabled child must be incapacitated prior to age 26. 2 See requirements above for Spouse or Domestic Partner for more information related to tax returns or other proof of joint financial arrangement. 3These documents only verify the disabled child’s eligibility as a dependent. Your health plan determines the disability status of the child.

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