Department of Management Services

Dependent Eligibility Verification Phase III

The Division of State Group Insurance (DSGI) is requesting documents as part of a monthly quality assurance review to confirm that an enrollee’s dependent(s)—newly added and existing—are eligible for insurance coverage. This process applies to new hires, marriages, births and other Qualifying Status Change (QSC) events. Only enrollees captured in a random sample of QSC events will receive the documentation request (Adobe PDF Document 403.20 KB) either by U.S. postal service or email if an email address is provided in People First. If you receive a request for documentation from us, you have 60 calendar days from the date of the request to comply and provide required documents for all of your dependents that are enrolled in any state provided benefit.   

If DSGI does not receive complete, legible documents that prove dependent eligibility, insurance coverage will be terminated prospectively for the dependent(s) in question. The following table lists the types of eligible dependents and documents required to verify each relationship:

 

Dependent
Required Document(s)
1. Legal spouse

a. Government-issued marriage certificate that includes the date of marriage between the enrollee and spouse and

b. If married for 12 or more months, a transcript of the most recent federal tax return listing both enrollee and spouse. Visit www.irs.gov/individuals/get-transcript to obtain tax documents, if needed.

2. Biological child Government-issued birth certificate identifying the enrollee as the parent.
3. Adopted child

a. Government-issued birth certificate or

b. Records showing the adoption is final or

c. Adoption placement agreement.

4. Stepchild

a. Proof of marriage – see box 1 above and

b. Records showing that the dependent is the enrollee’s spouse’s biological or adopted child – see box 2 or 3 above.

5. Ward Records showing the enrollee or the enrollee’s spouse has legal guardianship or court-ordered custody of the dependent.
6. Newborn grandchild

a. Proof that the enrollee’s dependent is eligible for coverage – see boxes 2-7, as applicable, and

b. Proof that the enrollee’s  newborn grandchild is the biological child of his or her dependent – see box 2.

7. Foster child Records showing the enrollee or the enrollee’s spouse is the dependent’s foster parent.
8. Child with disability

a. For age 26 or older, proof of eligibility – see boxes 2-4, as applicable, and

b. Attending Physician’s Statement from the health plan to verify the disability.

9. Child age 26 to 30 
(end of calendar year of the 30th birthday )

a. Proof of  eligibility – see boxes 2-4, as applicable, and

b. Certification that enrollee’s over-age dependent is unmarried, has no dependents, lives in Florida or attends school in another state and has no other health insurance. See below for the Over-age Dependent Certification form (Adobe PDF Document 93.45 KB).

 
  • Documentation submitted to verify eligibility may be an original or a photocopy of an original document—we prefer a photocopy. Employees may redact any information on a document which is not necessary to verify the eligibility of the dependent.
  • To obtain copies of U.S. birth certificates:
  • All documents must be in English or certified English translation.

 

For enrollees who receive our request for documentation may submit documents in the following manner:

  • Email a cell phone picture of the documents or send scanned copies to DSGI.QATeam@dms.myflorida.com;
  • Fax documents to 850-488-0252; or
  • Mail a copy of the document to Division of State Group Insurance, P.O. Box 5450, Tallahassee, Florida 32314-5450.

Questions? Read our Frequently Asked Questions or call us at 850-921-4600.

 

Overage Dependent Certification (Adobe PDF Document 93.45 KB)

Sample Request Letter (Adobe PDF Document 403.20 KB)