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Cal Poly Pomona

Enrolling Family Members

Clip Art drawing of a family taking a walk with their dog.

When certain life events or circumstances occur, you are entitled to make special enrollment updates within 60 days of the event or change. The terms "family member" and "dependent" are used interchangeably. Both refer to your spouse, registered domestic partner, and eligible children under age 26. Eligible family members can be enrolled when you initially sign up for a CalPERS health plan or they can be added as described below.

Spouse or Domestic Partner

Your spouse or domestic partner can be added to your health plan if done within 60 days after the date of your marriage or registration of your domestic partnership. A copy of your marriage certificate or Declaration of Domestic Partnership and your spouse's or domestic partner's Social Security number are required. (Be sure to review CalPERS information online about domestic partners  to see specific requirements for enrollment.)

Children

Your natural-born children, adopted children, and stepchildren who are under age 26 can be added to your health plan, as outlined below:

  • Newborn children can be added within 60 days of birth and are covered from the date of birth.
  • Newly-adopted children can be added within 60 days of physical custody and are covered from the date of the formal adoption or placement for adoption.
  • Stepchildren under age 26 can be added within 60 days after the date of your marriage. The coverage will become effective the first day of the month following your completion of enrollment forms with Benefit Services.

Disabled Children Over Age 26

A child over age 26 incapable of self support because of a mental or physical condition that existed prior to age 26 and continuously since age 26 may be included when you first enroll, subject to approval by CalPERS.

Prior to enrollment of, or continuing enrollment of, a disabled child beyond age 26, you must submit a Member Questionnaire for the CalPERS Disabled Dependent Benefit form (HBD-98) and a Medical Report for the CalPERS Disabled Dependent Benefit form (HBD-34). These forms must be approved by CalPERS upon enrollment and updated upon request. For further assistance and information, contact Cal Poly Pomona Benefit Services.

Economically Dependent Children Under Age 26

Other children may be eligible if any of the following applies:

  • You have been granted legal custody or joint legal custody of the child;
  • The child resides with you (generally in absence of the natural or adoptive parents) and is economically dependent upon you; or
  • The child is the natural, adopted, step, or economically dependent child of your registered domestic partner.

Eligible economically dependent children under age 26 may be added to your coverage within 60 days of legal custody or date the dependent is acquired. Prior to enrolling another person's child, you must file either an Affidavit of Eligibility form or provide a copy of the court-ordered custody document. These must be updated upon request. Coverage will become effective the first day of the month following the date you complete enrollment forms with Benefit Services.