If You Are Adding a Dependent

You are required to provide eligibility verification and Social Security numbers for any dependents you include on your healthcare, dental or vision plan(s). Eligible dependents under our healthcare, dental or vision plans include:

• Your spouse or qualified domestic partner (same or opposite gender)
• Your children under age 26 for healthcare, dental and vision
• Dependent children of your qualified domestic partner if your partner is covered on the plan

Documentation includes:

• Spouse – marriage license or copy of the first page of your most recent federal tax filing
• Child – birth certificate, adoption paperwork, guardianship/custody paperwork or copy of the first page of your most recent federal tax filing
• Domestic Partner – proof that you have shared a permanent residence for a minimum of six months and continue to do so currently, or a copy of the first page of your most recent federal tax filing; if you reside in a state that recognizes civil unions and you have your civil union certification or domestic partner registry certificate, please provide

To submit your dependent documentation:

• Use the Open Enrollment Dependent Verification Form
• Make sure the form is complete and accurate
• Fax the form and documentation to 515.365.0692; OR
• Email the form and documentation to KindredVerifyFamily@mercer.com

If you fax the dependent verification documentation, keep your fax confirmation sheet for future reference. If you email the dependent verification documentation, keep a copy of your sent email for future reference. You may be asked to provide a copy as needed. In order to ensure your newly enrolled dependent’s coverage is reflected in the carrier’s system, you must fax or email the required documentation by December 5, 2016.

If you cover a same-sex spouse and have questions about tax implications, please contact your tax advisor.