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Changing Medical/Dental Enrollment
for Faculty, Staff & Librarians

Valid Dependent Verification Documents

To enroll your dependent, you must submit the following verification documents in addition to an Employee Medical & Dental Enrollment/Change Form.

All documents must be submitted in English. Documents written in a foreign language must be accompanied by notarized translations.

A dependent is defined as a spouse, Washington state‐registered domestic partner, and children.

To enroll or reinstate a spouse, you must provide a copy of ONE of the bulleted items below:

*If you are within 2 years of marriage, then only a marriage certificate or license is required.

To enroll or reinstate a Washington State-registered domestic partner or legal union, you must provide a copy of:

* If within 2 years of marriage or a state registered domestic partnership then only the marriage certificate/license or certificate/card of state-registered domestic partnership or legal union is required.

To enroll or reinstate a dependent child up to age 26, you must provide a copy of any ONE of the following bulleted items:

**If the dependent is the subscriber’s stepchild you must also verify the spouse/state registered domestic partner to enroll the child, even when the spouse/state registered domestic partner isn’t enrolling in PEBB.

Documentation for Foreign National UW Employees & Dependents:

Foreign national UW employees who are unable to present the required dependent documentation (above) may submit alternative documentation, such as copies of J-1 or J-2 visas. Alternative documentation will be considered on a case-by-case basis by the Health Care Authority. Please contact the Benefits Office at 206-543-2800 for assistance.

Disclaimer: The Qualifying Life Event(s) shown above highlights benefit options arising from a change in family status. It does not substitute for official plan documents. If there is a conflict between the information on this site and an official plan document, the official plan document will govern. Plan availability and eligibility may change depending on your employment status and/or actions of the Washington State Health Care Authority.

Changing Enrollment

Obtaining Vital Records from Foreign Countries
Most foreign countries document births, marriages, and deaths that occur within their boundaries. If you need a copy of a foreign record, contact the embassy or the nearest United States consulate in the country in which the marriage, birth, adoption, or death occurred.

The Centers for Disease Control and Prevention provides a helpful resource for where to write for a vital record.