Documentation Requirements for Dependents

Amendment to Documentation Requirements: Birth of a Child

The Benefits Department has temporarily amended the documentation requirements for newborn children to address the current delays in the distribution of birth certificates.

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COVID-19: Contacting the Benefits Department

In response to the COVID-19 pandemic, the Office of Human Resources has limited on-site support and is primarily working remotely. 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. For Benefits forms not completed online via Pitt Worx or DocuSign, please submit an inquiry online.

If you have a Benefits-related inquiry, including the submission of forms or documentation, the quickest way to receive assistance is to call the Benefits Department at 833-852-2210. You can also submit an inquiry at www.hr.pitt.edu/contact-ohr.

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 enrolling in or making changes to your benefits during the Open Enrollment period or as a new hire or re-hire, you must add your dependents in the Before You Enroll section in Pitt Worx and upload your documentation in the Document Records section in Pitt Worx prior to completing the enrollment process.
    • When selecting a Document Type from the dropdown list, please be sure to only choose one that has Benefits as the category.
  • If you experience a life event (qualified status change) and need to add or remove a dependent from your coverage, you must first submit a request to the Benefits Department so that a life event can be opened on your account. After the life event is opened, you will be able to update your dependents in Before You Enroll, upload your documentation in Document Records, and make changes to your benefits elections.

For quick reference on required documentation for reporting a life event (qualified status changes), please refer to this guide.

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.