Dependent Eligibility Verification

Purpose

When you enroll your spouse/partner and/or eligible dependent children, in any of your CU medical, dental, vision, life insurance or tuition assistance benefits, as a New Hire or due to a Life Event, CU requires documentation to verify their eligibility.

You must submit documentation of eligibility for each dependent as listed in the Dependent Eligibility Verification (DEV) form (see below).  If you do not provide the necessary documentation, your unverified dependents will be removed from your benefits plans.

Eligible dependents for CU benefits

  • Spouse
  • Common law spouse
  • Civil union partner
  • Domestic partners
  • Children under the age 27
  • Qualifying disabled children over the age of 27

Individuals who are NOT eligible for CU benefits

  • Parents, grandparents and great-grandparents
  • Siblings, nieces and nephews, aunts and uncles, and cousins
  • Grandchildren, and great-grandchildren
  • Ex-spouses
  • Renters, boarders, tenants, and employees
  • Any other individuals not listed in the eligible dependents definitions

When two members of a household are employed and/or retired with the university and/or university affiliates

  • Current employee:  You and your dependents cannot be covered as both an employee and a dependent for any CU medical, dental or vision plan. Dual coverage is allowed for life insurance.  A member may be insured as both a member and a dependent up to a maximum combined life Insurance and dependents life insurance benefit of $1,000,000.  A child may be insured by more than one member.
  • Retiree:  You and your dependents cannot be covered as both retiree and a dependent for any CU medical or dental plan. Dual coverage is allowed for life insurance.  A retiree may be insured as both a retiree and a spouse of an active employee up to a maximum combined optional life insurance benefit of $500,000.
  • Each parent employee/retiree may enroll in different plans and may enroll different dependent children under his or her coverage.

Supporting documents

DEPENDENT TYPE
Spouse Most recent Federal Tax return form showing a married filing status. You must include the signed signature page or Certificate of Electronic filing Or Marriage Certificate and one Secondary Verification Document
Common Law Spouse CU Affidavit of Common Law And One Secondary Verification Document
Civil Union Partner Civil Union Certificate And One Secondary Verification Document
Domestic Partner CU Affidavit of Domestic Partnership for Same Gender Domestic Partners. (Opposite Gender Partners not eligible until 7-1-2018) And Two Secondary Verification Document
Child under the age of 27 Birth or Adoption Certificate Or Court documents signed by a judge for parental responsibility or QMCSO
Disabled Child over the age of 27 Birth or Adoption Certificate And A medical certificate of disability or Notice of Determination from the Social Security Administration
SECONDARY VERIFICATION DOCUMENTS (must be dated within the last 60 days)
  • Joint ownership of residence or other real estate
  • Lease agreement on home or another property listing both names
  • Joint ownership of a motor vehicle
  • Designation of dependent as primary beneficiary of the employee's life inurance or retirement benefits
  • Utility bill listing the employee and dependent on the bill or two separate utility bills, one listing the employee and one listing the dependent at the same address.

Imputed Income

The IRS uses the term imputed income to describe the value of any benefit or service that is considered income when calculating your federal taxes.  Know your taxation.  Some benefits and some dependent groups may be subject to taxation.  Learn what the IRS categorizes as imputed income.

Online form

Access and complete the online Dependent Eligibility Vertification in your employee portal:

  1. Log in to the employee portal
  2. In the CU Resources area, open the dropdown menu and select Forms
  3. Click the Benefits tile
  4. Click the Dependent Eligibility tile, and complete the form

Paper form

If you are unable to complete the Dependent Eligibility Verification in your employee portal, a paperform can be downloaded below. 

If you choose to click the employee portal option, remember to log into your portal before you click the link in the attached document. This will ensure you are routed to the correct place. 

Last updated: 2/2022

Download the form below.