There are time-sensitive dates and deadlines to meet to keep your loved ones enrolled in your health and dental plans. That’s why we’ve provided the following information and resources.
Certifying Your Disabled Dependent
Can I enroll my disabled dependent who is turning 26 years old?
You may be able to enroll a child as a disabled dependent if they are incapable of self-support due to a mental or physical condition which existed prior to age 26, and continuously since then.
In addition, the child must be enrolled in a CalPERS health and/or dental plan prior to turning age 26. If you are enrolling as a new employee and your disabled dependent is over the age of 26, the dependent must be enrolled during your initial enrollment opportunity as a new employee and continuously thereafter.
How do I enroll my disabled dependent?
Initial Certification Is Your First Step
- For subscribers already enrolled in the CalPERS health program, the request to enroll a disabled dependent must be submitted 90 days before, or up to 60 days after, the dependent turns age 26. New employees have 60 days from their hire date to submit the request to enroll a dependent age 26 or older.
- The subscriber and the dependent’s physician specializing in their disability must complete and submit a Disabled Dependent Member Questionnaire and Medical Report (HBD-34) (PDF) to CalPERS (see exception below for Kaiser Permanente members).
You Must Recertify
- Ninety days prior to the expiration of the disabled dependent’s certification, subscribers are required to submit a new HBD-34 form.
- If you are unable to submit the disabled dependent recertification in a timely manner, your dependent’s coverage will be permanently canceled, and you will be unable to reenroll them. If a disabled dependent over the age of 26 is removed from CalPERS health and/or dental benefits for any reason, the removal is permanent, and they are not eligible for future reinstatement.
Who do I contact for help and to start the process of certifying my disabled dependent?
| For | Contact |
|---|---|
| Active Members | Your health benefit officer |
| Retirees | CalPERS |
Where can I find the disabled dependent form to complete?
The Disabled Dependent Member Questionnaire and Medical Report Form (HBD-34) (PDF) and Authorization to Disclose Protected Health Information Form (PDF) can be found on our website, or you can contact your employer or us at 888 CalPERS (or 888-225-7377). After the initial certification, when it’s time to recertify your dependent, the required forms will be mailed to you 90 days prior to the certification expiration date.
Tips to Prepare Your Documentation
- The physician specializing in the dependent’s disability is to complete all the information in Part B and C on the medical report. The report cannot be completed by a nurse practitioner or other health professional.
- The medical report must be faxed to CalPERS directly from the physician with a fax coversheet. Kaiser members can send the report directly to CalPERS and we will confirm the report with Kaiser.
Certifying a Parent-Child Relationship
What is a parent-child relationship?
A “parent-child relationship” is established when you intentionally assume parental status or duties over a child who is not your adopted, step, or recognized natural child, and meet specific enrollment criteria.
How can I certify a parent-child relationship?
A parent-child relationship can be certified by submitting the Affidavit of Parent-Child Relationship (HBD-40) (PDF) along with supporting financial and residential documentation showing legal parental status or duties/guardianship over the child. For examples of acceptable documents, please review the list available on the Affidavit of Parent-Child Relationship form.
Who do I contact for help and to start the process of adding a parent-child relationship dependent?
| For | Submit to |
|---|---|
| Active Employees | Your health benefit officer |
| Retirees | CalPERS |
Tips on Supporting Documentation
For the initial certification, supporting documents for dependents under 18 can include residential and financial statements. However, in the following year, supporting documentation will require the first page of your most recent federal or state tax return which shows the parent-child dependent as a tax dependent.
Tax-Exempt Members
In lieu of a tax return document, provide proof of tax-exempt documentation along with residential and financial statements.
Newborn Children
Submit hospital bills that include both your and your dependent’s name. In lieu of a birth certificate, you may submit the hospital’s declaration of birth. The Social Security card may be used to show a common address.
Note: Any financial documentation you submit must include BOTH your name and the dependent’s name with the common address.