Departments

Rules for Coverage Eligibility

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If you add dependents during Open Enrollment, you will receive a letter requesting documentation to verify the new dependent that was added to coverage to ensure the dependent is “eligible” to be covered on the County’s plan. The letter will include detailed instructions on how and where to submit your documentation. For dependents currently on your plan, you will not need to reverify eligibility.
 

Coverage Type

Age

Eligibility Definition

Documents Required for Verifying Eligibility

Spouse

N/A

  • Person to whom you are legally married

  • Marriage Certificate

Domestic Partners

At least 18 years old

  • Meet County Domestic Partner Eligibility Requirements

Natural Child(ren)

Under Age 26

  • Minor or Adult Child(ren) of Employee who is under age 26yrs

  • Birth Certificate

Step Child(ren)

Under Age 26

  • Minor or Adult Child(ren) of Employee Spouse who is under age 26yrs

  • Birth Certificate -and-

  • Marriage Certificate showing Spouse as Parent

Children Legally Adopted/Wards

Under Age 26

  • Minor or Adult Child(ren) legally adopted by Employee who is married or unmarried under age 26yrs

  • Court documentation (Must include presiding Judge Signature & Court Seal)

Children of Domestic Partners

Under Age 26

  • Minor or Adult Child(ren) of Employee Domestic Partner who is under age 26yrs

Disabled Children

No age limit

  • Natural Child, Step Child or Adopted Child of Employee who is over age 26yrs and incapable of self­care due to physical or mental illness.

  • Birth Certificate -and-

  • Certification of Disability from Social Security ­or-

  • Document of Disability from Physician if not SSA Certified

Other Qualifying Relatives

Under Age 24

  • Meets Requirements of IRS Code. Sec. 105(b)

  • Not married

  • Must be a full time student if over the age of 19.

 

Note: If you are married to a county employee or the dependent of a county employee and would like to enroll in benefits through them, please contact the Benefits Division at (650) 363-1919 or at benefits@smcgov.org for assistance in waiving your dental and vision coverage.

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