Dependent Eligibility Verification
You'll need to provide proof of eligibility when you add new dependents to your benefits coverage (this also applies if you remove dependents from your coverage and then re-enroll them at a future date). See below for more details.
For a list of documents that can verify the eligibility of your dependents, click here. For a list of the criteria that determine an eligible dependent, please consult the relevant section of the Health and Welfare Summary Plan Description [pdf].
Penn requires that all dependents newly enrolling be verified as eligible for benefits coverage (this also applies if you remove dependents from your coverage and then re-enroll them at a future date). This requirement is part of an important initiative to ensure legal compliance and good governance, and is intended to aid in the University’s continuing efforts to control healthcare costs.
What does this mean for you? If you are a Penn staff or faculty member and you are enrolling new dependents or re-enrolling previously-covered dependents*, you'll need to provide documentation verifying their eligibility under Penn's plan rules. It’s important to understand that if you can’t produce that documentation when Penn requests it, any unverified dependents will be removed from your coverage retroactive to the original date on which they were added. Please keep reading for answers to the following questions:
Dependent eligibility verification is a growing trend nationwide. This type of verification helps us to ensure that Penn’s benefits plans are there for the people who need them—our employees and their dependents. The University also has certain fiduciary duties under federal law, as well as under our own Principles of Responsible Conduct. Dependent eligibility verification is one of the best ways for us to way to meet these responsibilities. Finally, dependent eligibility verification can also help Penn in our continuing quest to control healthcare costs. Keeping healthcare affordable for all employees is critically important, and ineligible dependents drive up the cost of benefits for everyone.
There are several situations in which you may newly enroll or re-enroll* an eligible dependent in your benefits coverage:
- During your new employee enrollment;
- During Open Enrollment;
- Following a qualifying life event change; or
- Following a change in your work status
After you newly enroll or re-enroll* a dependent in any of these circumstances, you will receive a personalized letter at your home address from the Penn Benefits Center. This letter will ask you to provide specific documentation verifying that your newly-enrolled or re-enrolled* dependent(s) are eligible to be covered under Penn’s plans. The letter will also explain exactly how and when to submit this documentation. Examples of documents that might be requested include birth certificates, marriage certificates, and certifications of domestic partnership. A full list of acceptable documents is available here.
Eligible dependents include but are not limited to your spouse or same-sex domestic partner, children up to age 19 (or up to age 23 if full-time college students), and disabled children age 19 or older. For further clarification, you should thoroughly review the relevant section of the Health and Welfare Summary Plan Description [pdf].
If you provided proof of eligibility for your dependents when they were newly enrolled, and you keep those same dependents on your coverage from one year to the next, you do not need to provide verification again during Open Enrollment. However, if you have a dependent child who is an overage student, you will need to provide updated documentation of his/her student status each year.
If you have questions about verifying your dependents’ eligibility, please call the Penn Benefits Center at 1-888-PENN-BEN (1-888-736-6236).
*You'll need to provide proof of eligibility if you’re re-enrolling a dependent who had previously been covered under your benefits. Once you remove dependents from your coverage, they become subject to the same verification process as new dependents if you re-enroll them at a future date.