Eligible Dependents

If you are legally married, even if physically separated, you will need:

• Most recent filed Federal Tax Return with signature page or e-file confirmation (financial information can be redacted) showing you are married filing jointly or married filing separately, OR
• Valid marriage certificate between employee/retiree and spouse issued by any state, AND
• Proof of joint ownership dated within the last six months. Documents for proof of joint ownership include:

A mortgage or bank statement, residential leasing agreement, property tax bill, or joint credit card statement. Documents must include both the employee’s/retiree’s name and the spouse’s name. If within two years of marriage, then only the valid marriage certificate is required.

• Valid marriage certificate between employee/retiree and spouse issued by any state only (if within two years of marriage, then only the marriage certificate is required)

If you are legally married by a Common Law Marriage, you will need:

• Most recent filed Federal Tax Return with signature page or e-file confirmation (financial information can be redacted) showing you are married filing jointly or married filing separately, OR
• Texas Declaration of Informal/Common Law Marriage from the County where the marriage was recognized/recorded or Declaration of Informal Marriage issued by another state, AND
• Proof of joint ownership dated within the last six months. Documents for proof of joint ownership include:

A mortgage or bank statement, residential leasing agreement, property tax bill, or joint credit card statement. Documents must include both the employee’s/retiree’s name and the spouse’s name. If within two years of marriage, then only the valid marriage certificate is required.

• Birth certificate of the biological child(ren) proving relationship of child(ren) to employee/retiree, OR
• Certification of Vital Records proving relationship of child(ren) to employee/retiree, OR
• Verification of Birth Facts Form* proving relationship of child(ren) to employee/retiree, OR
• Valid Medical Support Order requiring employee/retiree to provide medical coverage, OR
• Paternity test accompanied by Court Order, Medical Support Order or reissued Birth Certificate

* If the child(ren) is/are under 6 months old, documentation on hospital letterhead or Verification of Birth Facts Form indicating the birth date of the child(ren) will be accepted as temporary enrollment but must be followed by the birth certificate within 60 days from date of birth.

• Birth certificate of the child(ren) showing the child(ren)’s parent is the employee’s/retiree’s spouse, AND
• Proof of marriage which includes the marriage certificate showing legal marriage between the employee/retiree and the child(ren)’s parent, AND
• Proof of joint ownership dated within the last six months.

In lieu of the marriage certificate and proof of joint ownership, you can provide your most recent filed Federal Tax Return with signature page or e-file confirmation (financial information can be redacted) showing you are married filing jointly or married filing separately).

The documents will depend on the current stage of the adoption.

• Valid Pre-Adoption Placement Order issued by a Licensed Child Placement Agency, OR
• Valid Court Order naming employee/retiree as Managing Conservator of Child(ren), OR
• Valid Court Order of Adoption, OR
• Birth certificate of Child(ren) with Adoptive Parent(s), OR
• Valid Medical Support Order requiring employee/retiree to provide medical coverage

• Valid document (e.g., birth certificate, adoption papers) proving relationship to employee/retiree, AND
• A doctor’s statement regarding the physical or mental condition of the dependent, whether the dependent can maintain self-sustaining employment, and whether the condition occurred before the child(ren) reached age 26 must be submitted. If the dependent is currently enrolled, the appropriate form must be submitted before the dependent reaches age 26:

1. For medical coverage including optional coverages (if applicable) submit the BCBSTX Dependent Child’s Statement of Disability form.
2. For optional coverage only not including medical, submit the TAMUS Dependent Child’s Statement of Disability form to System Benefits Administration for review.

• Most recent filed tax return*, including the signature or confirmation of e-file, showing the grandchild(ren) as a claimed dependent of the employee/retiree (financial information can be redacted), AND
• Birth Certificate of grandchild(ren)’s biological parent (i.e., child of employee/retiree), AND
• Birth Certificate of grandchild(ren) or Verification of Birth Facts Form**, AND
• Dependent Grandchild Certification Form (HR 120)

* If the grandchild(ren) is/are born in the current tax year, most recent filed tax return is not required, but will be required in subsequent tax years during the annual grandchild certification audit.

** If the grandchild is under 6 months old, documentation on hospital letterhead or Verification of Birth Facts Form indicating the birth date of the child(ren) will be accepted as temporary enrollment but must be followed by the birth certificate within 60 days from date of birth.

• Valid Court Order establishing a parent-child relationship between employee/retiree and foster child

• Valid Court Order naming the employee/retiree as the legal guardian. Eligible up to age 18 unless court order defines otherwise.

• Valid Court Order naming the employee/retiree as the managing conservator. Eligible up to age 18 unless court order defines otherwise.