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 Legal Dependent Verification Form SUNY Potsdam 2020

2020-2025 Form

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Instructions and help about Legal Dependent Verification Form SUNY Potsdam

as a benefit eligible employee you may include eligible family members on your coverage in addition to yourself you may also enroll your spouse or state registered domestic partner children through the age of 25 extended dependence in your your spouse or your state registered domestic partner's legal custody and children of any age with disabilities when you add family members to your coverage you are required to provide documentation that proves their eligibility submit dependent verification documentation with your Employee Enrollment change form to your personnel payroll or benefits office a list of acceptable dependent verification is available on the PEB website at hca.wa.gov PBB employees adding eligible dependants who are not qualified tax dependents are required to complete a declaration of tax status form the tax status of these family members does not affect eligibility for PEB coverage there may be tax ramifications when adding a domestic partner and their dependence

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