Eligibility Requirements for Spouse/Dependents:

For a Spouse [formal marriage or common law], Domestic Partner or Child to be added as a Dependent, their last name must match that of the Policyholder. If your last names do not match, supporting documentation is required to verify eligibility.

• Spouse: Copy of marriage certificate is required.
• Common Law Spouse: State must recognize Common Law Marriage. Additional documentation may be required according to state statutes, which may include but not be limited to copies of joint federal income tax returns, proof of employer provided medical insurance, or other employer provided spousal benefit.
• Domestic Partnership: Proof of State or local jurisdiction registration is required where recognized.  In those states where Domestic Partnership is not recognized, proof of employer provided health insurance or other spousal benefits provided by Member’s employer is required.
• Children: Copy of birth certificate is required.