Documentation Requirements for Dependents

COVID-19: Contacting the Benefits Department

In response to the COVID-19 pandemic, the Office of Human Resources is working remotely until further notice. During this time, Craig Hall is not open to the public; walk-ins will not be accepted and forms cannot be dropped off in-person or faxed. During this time, we recommend submitting all requests and inquiries online in lieu of sending physical mail or leaving phone messages.

If you have a Benefits-related inquiry, including the submission of forms or documentation, the quickest way to receive assistance is to submit an online request. You can also call the Benefits Department at 833-852-2210.

Children can be covered until the last day of the month in which they turn age 26. Disabled dependents can be covered beyond age 26, if additional documentation is submitted. In the event of divorce or dissolution of domestic partnership, that individual must be removed through a status change request and will be offered COBRA insurance coverage. Enrollment will not be processed without all required documentation. Please note that international documents without an official English translation will not be accepted.

Supporting documentation must be submitted in Pitt Worx prior to making or updating your enrollment elections.

  • If you are adding a spouse due to a marriage, adding a child due to birth or adoption, or adding a domestic partner, you should add the dependents in the People to Cover section in Pitt Worx and upload your documentation in the Document Records section in Pitt Worx prior to completing the enrollment process or initiating a life event.
  • If you are removing a dependent from your coverage, you must submit your documentation in Pitt Worx first (via the People to Cover and Document Records sections), and then submit a request to the Benefits Department so that a life event can be opened on your account and so that you can make changes to your benefits elections.

Relationship Type

Required Documentation

 Spouse

Marriage Certificate

 Domestic Partner1

University approved Affidavit of Domestic Partnership

 Natural Child

Birth Certificate (A verification of birth can used as a placeholder, however a birth certificate must be submitted within 61 days of the child's birth.)

Adopted Child

Adoption decree stamped by the circuit clerk (An adoption placement agreement can be used as a placeholder, however the adoption decree must be submitted within 61 days of the adoption date.)

Step Child

 Birth Certificate indicating your spouse is the child's parent and marriage certificate indicating you are married to the child's parent

Child of Approved Domestic Partner

Birth Certificate indicating your domestic partner is the child's parent and the University approved Affidavit of Domestic Partnership indicating you are in a domestic partnership with the child’s parent.

Disabled Over Age Child

Eligibility will be continued past the age of 26 for dependent children who, as medically certified by a physician, are incapable of self-support due to mental or physical disability, mental illness or a developmental disability that started before age 19. Initial certification with the insurance carriers as well as an annual recertification is required. Please contact carriers with questions.

Legal Guardianship

Court documentation signed by a judge and stamped by the circuit clerk

Adjudicated Child

Judicial Support Order from a judge or a copy of Qualified Medical Support Order with the page that indicates the member must provide health insurance through the employer.

Death of a Dependent

A death certificate is required to remove a dependent from coverage in the case of death.

Divorce

A Divorce Decree is required to remove a former spouse from coverage in the case of a divorce.

Spouse/Domestic Partner Employment Change

Used to add or remove a spouse/domestic partner due to an employment change. Acceptable documentation includes:

  • A confirmation statement of benefits that outlines coverage, enrollees, and effective start date.
  • A letter from the employer's HR department or insurance company that outlines coverage, covered person(s), and effective start date of coverage.
  • Letter or statement that you/your dependents are newly eligible for state-sponsored coverage.

1Review this page for more information on Domestic Partner benefits.