Enrollment of Dependents

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Eligibility and Enrollment of Dependents

Retired members, surviving spouses/beneficiaries and/or former spouses enrolled in an ACERA sponsored medical plan (health, dental and/or vision) may also enroll eligible dependents for coverage. A retiree pays 100% of their dependent(s) health, dental and vision coverage. The cost of the premium is deducted from the retiree's monthly retirement allowance.

Eligible dependents may be enrolled into a health and vision plan upon retirement; within 30 days or qualifying event (i.e. birth, marriage, adoption, loss of existing coverage); or during the ACERA Open Enrollment period. You may discontinue/cancel dependent coverage at anytime by contacting ACERA. However, please note that re-enrollment of a dependent for health, dental and/or vision coverage may only occur during the annual ACERA Open Enrollment period.

To enroll a dependent, ACERA requires one of following documents:

SPOUSE/DOMESTIC PARTNER

Certified Marriage Certificate or License, or
ACERA-filed Domestic Partner Affidavit

DEPENDENT

Certified Copy of Birth Certificate, or
Original Church Baptismal Certificate with mother/father listed, or
Court-filed Guardianship/Adoption papers

The following chart lists the plan provider's dependent enrollment eligibility rules:

Delta Dental	Blue Cross	Kaiser Permanente	Secure Horizons	Vision Service Plan (VSI)
To age 19	To age 19	To age 19	Thru age 18	To age 19
Unmarried child between age 19 and 24, provided that child is a full time student *	Unmarried child between age 19 and 24, provided that child is a full time student *	Unmarried child between age 19 and 24, provided that child is a full time student *	Unmarried child between age 19 and 24, provided that child is a full time student *	Unmarried child between age 19 and 24, provided that child is a full time student *
Unmarried child over 19 and incapable of supporting self due to mental or physical handicap incurred prior to age 19**	Unmarried child over 19 and incapable of supporting self due to mental or physical handicap incurred prior to age 19**	Unmarried child over 19 and incapable of supporting self due to mental or physical handicap incurred prior to age 19**	Unmarried child over 19 and incapable of supporting self due to mental or physical handicap incurred prior to age 19**	Unmarried child over 19 and incapable of supporting self due to mental or physical handicap **
	Any other unmarried dependent person under 24 entirely supported by and residing with subscriber who is court appointed guardian***	Any other unmarried dependent person under 24 entirely supported by and residing with subscriber who is court appointed guardian***

* Proof of attendance at accredited school, college or University must be submitted to ACERA Benefits Dept.

** Proof of incapacity must be submitted upon carrier request.

*** Guardianship must have been appointed prior to dependent's 18th birthday.

- Last Modified: 10 / 25 / 2005