Human Resources Service Center

Changing Plans, Adding or Removing Dependents

Changing Plans

  • Plan changes or adding/deleting eligible dependents may only occur during the annual open enrollment period OR after submitting supporting documentation of a qualifying life event*.
  • All plan changes require supporting documents and a completed Benefit Enrollment/Change Worksheet.
  • Open enrollment occurs annually (date is determined by CalPERS) and is usually in the fall, with all changes taking effect on January 1st of the following year.

*Qualifying Events include:

  • Loss of other qualified coverage (you must provide proof of when the coverage ended).
  • Change of residence address.
  • For additional information, please visit the CalPERS Health Program Guide (PDF).

Adding or Removing Dependents

  • Supplemental documentation and Social Security numbers are required to enroll all dependents.
  • You may enroll your spouse or domestic partner to your health plan within 60 days of your marriage or registration of your domestic partnership
  • You may enroll your newborn, adopted or stepchild to your health plan within 60 days of the child’s birth, placement, your marriage or registration of your domestic partnership.
  • Dependents may be removed from your plan at any time. If dependent has gained other coverage, a copy of their new insurance card is required.
  • If you divorce or terminate a domestic partnership, your former spouse/domestic partner is no longer eligible to be enrolled in your health coverage, even if the court orders you to provide health coverage for them. The coverage terminates on the last day of the month in which the final decree of divorce or termination is granted.

California Code of Regulations (CCR), sections 599.502(f) (2) and 599.506(c) (1), limit the liability of health plans for reimbursement of health premiums to members and employers to the amount of excess health premiums paid for a period of up to six months prior to the date on which the action is processed and recorded, pursuant to the member’s request for retroactive cancellation or deletion of the ineligible family member.

Members who fail to report an enrollment change in a timely manner could be liable for retroactive reimbursement to their employer of premiums in excess of six months prior to the date on which the action is processed and recorded. In addition, members may be liable for costs incurred as a result of services delivered to an ineligible dependent.

Making a change Process

  1. To add or remove dependents, complete the Benefit Enrollment/Change Worksheet (PDF) (including the Declaration of Health Coverage, HBD-12a).  
  2. Submit the completed form(s) and copies of required supplemental documentation to the Benefits Unit.
  3. The Benefits Unit will:
    • Review the benefit worksheet and required supporting documentation.
    • Notify you if additional information or documentation is needed.