Dependent Coverage

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$10 Dental For Your Dependents*

Starting this year, if you work 120 hours or more per month, you can enroll your dependent children in dental coverage for just $10 a month.

You now have 2 options to choose from when adding a dependent to your coverage:

When you enroll your dependent(s), you will need to select one of the Dependent Coverage Options below. To do this, follow the instructions on the Health Benefits Application or online using Health: My Plan. Need help? Call 1-877-606-6705.

 

 

The 80 Hour Option

Best for caregivers who work 80-119 hours per month. Coverage for your dependent will not begin until you work 80 hours or more per month.

  • Full medical and dental package at the full premium cost ($686-$786 per month, plus $25 per month for your coverage).
 

The 120 Hour Option (includes $10 dependent dental)

Best for caregivers who work 120 hours or more per month. Coverage for your dependent will not begin until you work 120 hours or more per month.

  • Full medical and $10 dental ($628-$697 total per month for your dependent, plus $25 per month for your coverage).
  • OR Dental coverage only for $10 per month (plus $25 per month for your coverage).

If your monthly payment is not received or your hours drop below what is required for your Dependent Coverage Option, your dependent will lose coverage.

You can only choose or change your Dependent Coverage Option when you enroll for the first time, or during the annual Open Enrollment period (every July 1-20). If you have a Qualifying Life Event, such as having a baby, you can still add a dependent to your coverage. But, if you want to change your Dependent Coverage Option, you may need to wait until the next Open Enrollment period.

*Available to caregivers who work 120 hours or more per month and are on the KPWA HMO, Aetna and KPNW plans only. If you are enrolled in the KPWA POS plan and would like to get $10 dental coverage for your dependent, you will need to change your medical plan. Call 1-877-606-6705 for help.

 

How to Enroll and Verify a Dependent

There are several steps to enrolling a dependent on your coverage and verifying your relationship to them. You can do this online with Health: My Plan or by mail.

Enroll a Dependent Online  Enroll a Dependent by Mail
  • Fill out the dependent section of the Health Benefits Application, and submit it using  Health: My Plan.
  • Submit a document that verifies your relationship to your dependent(s) within 60 days of submitting your Application using  Health: My Plan.
  • You will get a confirmation letter within 30 days, by mail or email.
  • Fill out the dependent section of the Health Benefits Application, and send it to the address on the Health Benefits Application (by July 20 during Open Enrollment).
  • Send a document that verifies your relationship to your dependent(s) within 60 days of sending your Application to the address on the Health Benefits Application.
  • Begin paying through payroll deduction.

More Details About Dependent Verification:

  • You can submit your Dependent Verification document with your application, but you have 60 days after your application is received to submit it. Your application is NOT complete until you send dependent verification. 
    • If you choose to send your Dependent Verification document after you submit your Health Benefits Application, make sure to include your name and date of birth with it so it can be matched to your application.
  • Make sure to send a copy and not the original document.

 

Who Can I Add to My Coverage?

You can enroll eligible children (through their 26th birthday) in dependent coverage. If you choose to enroll your dependent(s), you will need to verify your relationship to them. You can enroll multiple eligible children in coverage and your monthly cost will be the same no matter how many children you have enrolled.

  • For example: If you enroll 2 children in the 120 hour option for $10 dental coverage only, your monthly dependent coverage cost will be $10 total for both dependents.

Below is a list of qualified child dependents. Click the “+” to see which documents you can use as verification for each type of dependent. If you have questions or need help enrolling a child dependent, call SEIU 775 Benefits Group Customer Service at 1-877-606-6705 from 8 a.m. to 6 p.m., Monday to Friday.

 

You can enroll your biological child as a dependent. Here is a list of acceptable documents:

  • Government-issued birth certificate that includes all parents’ names. 
  • The most recent year’s federal tax return that includes the child(ren) as a dependent(s) and listed as a son or daughter. Make sure to black out financial information. 
  • Hospital certificate with the child’s footprints on it. Must show the name of the parent who is the subscriber, the subscriber’s spouse or the subscriber’s state-registered domestic partner. 
  • Court-ordered parenting plan. 
  • National Medical Support Notice. 
  • Defense Enrollment Eligibility Reporting System (DEERS) registration. 
  • Valid J-2 visa issued by U.S. government.

You can enroll your adopted child as a dependent. Here is a list of acceptable documents:

  • Birth certificate or adoption certificate. 
  • The most recent year’s federal tax return that includes the child(ren) as a dependent and listed as a son or daughter. Make sure to black out your financial information. 
  • Certificate or decree of adoption. Must show the name of the parent who is the subscriber, the subscriber’s spouse, or the subscriber’s state-registered domestic partner. 
  • Court-ordered parenting plan. 
  • National Medical Support Notice. 
  • Defense Enrollment Eligibility Reporting System (DEERS) registration. 
  • Valid J-2 visa issued by U.S. Government. 

You can enroll your stepchild as a dependent. Here is a list of acceptable documents:

  • Birth Certificate as well as government-issued marriage certificate and a  federal tax return within the last 2 years with your spouse listed and proof of joint ownership (mortgage statements, bank statements, credit card statements, lease/rental agreements). 
  • The most recent year’s federal tax return that includes the child(ren) as a dependent and listed as a son or daughter (make sure to black out your financial information). 
  • Court-ordered parenting plan. 
  • National Medical Support Notice. 
  • Defense Enrollment Eligibility Reporting System (DEERS) registration. 
  • Valid J-2 visa issued by U.S. Government.

You can enroll a child you have legal guardianship over as a dependent. Here is a list of acceptable documents:

  • Legal documentation from state or federal government that shows legal guardianship status. 
  • The most recent year’s federal tax return that includes the child(ren) as a dependent and listed as a son or daughter. Make sure to black out your financial information.
  • Court-ordered parenting plan. 
  • National Medical Support Notice. 
  • Defense Enrollment Eligibility Reporting System (DEERS) registration. 
  • Valid J-2 visa issued by U.S. Government. 

You can enroll your foster child as a dependent. Here is a list of acceptable documents:

  • Original foster child certification and copy of documentation of regular and substantial support of the child. 
  • The most recent year’s federal tax return that includes the child(ren) as a dependent and listed as a son or daughter. Make sure to black out your financial information. 
  • Court-ordered parenting plan. 
  • National Medical Support Notice. 
  • Defense Enrollment Eligibility Reporting System (DEERS) registration. 
  • Valid J-2 visa issued by U.S. Government.

You can enroll your domestic partner’s child as a dependent. Here is a list of acceptable documents:

  • Government-issued birth certificate; includes name of the domestic partner. 
  • Court orders naming the domestic partner as the legal guardian. 
  • The most recent year’s federal tax return that includes the child(ren) as a dependent and listed as a son or daughter. Make sure to black out your financial information. 
  • Court-ordered parenting plan. 
  • National Medical Support Notice. 
  • Defense Enrollment Eligibility Reporting System (DEERS) registration. 
  • Valid J-2 visa issued by U.S. Government.

**If you are enrolling your stepchild or your domestic partner’s child, you may need to fill out additional paperwork. Call SEIU 775 Benefits Group for help at 1-877-606-6705 from 8 a.m. to 6 p.m., Monday to Friday.