• REQUIRED DOCUMENTATION INCLUDES:

    • Birth Certificate or letter of live birth
    • Adoption papers or legal papers indicating placement for adoption
    • Court order regarding legal guardianship of a child
    • Marriage certificate stating date of marriage
    • Divorce decree (applicable pages)
    • Death certificate
    • Letter from your spouse's or dependent's employer or open enrollment notice including enrollment dates and effective date
    • Letter from your spouse's or dependent's Human Resources Department or insurance plan with insurance cancellation date
    • Letter from your spouse's or dependent's Human Resources Department or insurance plan explaining circumstances regarding a significant cost change, a significant coverage curtailment, a significant improvement, a new option or a change in coverage
    • Court order requiring you to cover a child or an order requiring someone else to provide coverage for your dependent
    • Copy of your Medicare card or Medicare/Medicaid letter
Last Modified on June 9, 2009