Verifying Dependent Eligibility: List of Acceptable Documents

 

Many different types of dependents are eligible for healthcare coverage under Penn’s rules*. The list of documents below describes what will be accepted as proof of eligibility for each type of dependent.

For each dependent you’re covering under Penn’s benefits, you must provide appropriate documentation. Please do not send original documents, as they will not be returned—copies of the documents are encouraged instead.

For all dependent types, there is one item which is the preferred documentation; please make every effort to supply this preferred item. However, since we understand that this may not be feasible in all cases, we will also accept alternate documentation for certain dependent types as specified in the list below.

If you're covering a child over the age of 26 who is disabled, you’ll need to provide documentation to your medical insurance carrier certifying the disability.

Please call the Penn Benefits Center at 1-888-PENNBEN (1-888-736-6236) if you have any questions about the documents listed below.

*Please note that there are specific criteria governing the eligibility of dependents, particularly children, which are not listed below. For a full description of the rules that determine whether your dependents are eligible for health care coverage through the University, consult the relevant section of the Health and Welfare Summary Plan Description [pdf].

Dependent Type	Preferred Documentation	Alternate Documentation
Spouse	Marriage Certificate1	Redacted 2010 tax return2 OR Current visa documentation3
Same-Sex Domestic Partner	University of Pennsylvania Affidavit of Domestic Partnership4	N/A
Common Law Spouse	University of Pennsylvania Affidavit of Common Law Marriage5	N/A
Birth Child up to Age 26	Birth Certificate1	Redacted tax return from your most recent filing6 OR Current visa documentation3
Adopted Child up to Age 26	Adoption Certificate1	Redacted tax return from your most recent filing6 OR Current visa documentation3
Child up to Age 26 for Whom You Are the Legal Guardian	Proof of legal guardianship7	Redacted tax return from your most recent filing6 OR Current visa documentation3

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¹Or equivalent from a foreign country in the case of foreign nationals.
²Redacted means that financial information and Social Security Numbers should be blacked out. Filing status must state married (filing jointly or separately).
³For foreign nationals.
⁴Including appropriate documentation as indicated on the Affidavit of Domestic Partnership.
⁵Common law marriage is governed by state law. The following states recognize common law marriage, or did recognize it before a certain date. The University recognizes common law marriages established in states that recognize the relationship, as well as common law marriages established prior to the date the institution was abolished in a state that once recognized it:

Alabama Colorado Georgia (prior to 1/1/1997) Idaho (prior to 1/1/1996) Iowa Kansas Montana New Hampshire (for inheritance purposes only)

Ohio (prior to 10/10/1991) Oklahoma (prior to 11/1/1998) Pennsylvania (prior to 9/13/2003) Rhode Island South Carolina Texas Utah Washington, D.C.

⁶Redacted means that financial information and Social Security Numbers should be blacked out. Your child must be listed as a dependent.
⁷The most common way to establish legal guardianship is through a court order. If you have proof of your status as a legal guardian other than a court order, it will be reviewed on an individual basis.