DEPENDENT DEFINITIONS AND DOCUMENTS REQUIRED
THINGS TO REMEMBER:
•••••

•

Only submit copies. Original documents will not be returned
Parent names and dates of birth or date of marriage must be visible on birth and marriage
certificatesIf submitting a 1040 Federal Tax Return, send the first page AND signed signature page
Black out social security number(s) appearing on any documents submitted
Joint ownership documents must be submitted with your government issued marriage certificate
and must show a date of issue in the last 6 months. Some examples of documents proving
joint ownership are:◦ Mortgage statements◦ Bank statements◦ Credit Card statements◦ Utility bills◦ Active rental or lease agreements◦ Home equity loan statement◦ Automobile registration
Black out all monetary amounts and account number

Definition of Dependent

Documentation Required

SpouseSubmit documents from Group A or Group B.

••

Must be your lawfully married
spouseMust not be legally separated

Group A• Page 1 and signed signature page of your Federal
TaxReturn filed in the last 2 years
ORGroup B• Government issued marriage certificate; AND• Proof of joint ownership with an issue date in thepast 6 months (see “Things to Remember” above
for a list of joint ownership options)
Note: If you were married within the past 12 months, you
may submit only your government issued marriage certificate.

Registered Domestic Partner•

Must be in a Domestic
Partnership registered with agovernment entity

Submit documents from Group A or Group B.
Group A• Page 1 and signed signature page of your State
TaxReturn filed in the last 2 years
ORGroup B• State or County Declaration of Domestic Partnership;AND• Proof of joint ownership with an issue date in thepast6 months (see “Things to Remember” above fora list of joint ownership options)February 2022 - reviewed May 2024

Unregistered Domestic Partner••••••

Group A
Must be each other's sole
• Unregistered Domestic Partner Affidavit for UC Healthdomestic partner in a long-term
committed relationship and& Welfare Benefits Plans; AND
intend to remain so indefinitely• Proof of joint ownership with an issue date in the past 6Must not be legally married normonthsin another domestic partnershipMust not be related to each other Note: The Unregistered Domestic Partner Affidavit can be
Must be at least 18 years of age found on:• UnifyHR site under Resources: app.unifyhr.com
and able to consent to therelationship• UCNet: ucal.us/fmv
Must be financiallyinterdependent
Must share a common residenceChild under the age of 26
•
•
•

•
•

Submit documents from Group A.

Natural child◦ Must be your natural child
Adopted child◦ Must be your adoptedchild
Step child◦ Must be your spouse orpartner's natural, adopted,or foster child
Foster Child◦ Must be your foster child
Grandchild◦ Must be your or your
spouse or partner's
natural, adopted, or step
grandchild◦ Must be unmarried◦ Must be living with you
and dependent upon yourfor support◦ Must be claimed as a tax
dependent

February 2022 - reviewed May 2024

Submit documents as determined by your family member(s)'relationship type below.
Natural or Adopted Child• Government issued birth certificate listing parentnames; OR• Non-government issued birth certificate for children
under 6 months of age: OR• Adoption certificate; OR• Adoption placement agreement
Step Child• For step children, your spouse or partner must beeligible for the UC Health & Welfare benefits even if
they are not enrolled. Provide the required documents
listed in the appropriate family member category toverify spouse or partner.
• In addition you must submit one of the following:• Government issued birth certificate listing spouse orpartner name as parent; OR• Adoption Certificate listing spouse or partner name asparent
Foster Child• Foster care letter of placement
Grandchild• For step grandchildren, your spouse or partner must be
eligible for the UC Health & Welfare benefits even if
they are not enrolled. Provide the required documents
listed in the appropriate family member category toverify spouse or partner.
• In addition you must submit the following:• Government issued birth certificate or adoption
certificate listing parent names for grandchild; AND• Government issued birth certificate or adoption
certificate listing parent name for child; AND• Federal Tax Return filed in the last 2 years claimingchildChild under the age of 18•

Legal Ward◦ Must be unmarried◦ Must be living with you
and dependent upon yourfor support◦ Must be claimed as a tax
dependent◦ Must be your court
ordered legal wardChild aged 26 or older•

Legal Ward
• Court ordered document granting guardianship; AND• Federal Tax Return filed in the last 2 years claiming
child

Natural, Adopted, Step Child, and Grandchild or Step
Grandchild
Natural, Adopted, Step Child,• Provide the required documents listed previously in theand Grandchild or Step
appropriate family member category above, as proof
Grandchildthat the child is your or your spouse's or partner's◦ Must be a child as defined
natural or adopted child, your step child, grandchild, orabove
step grandchild; AND◦ Must be unmarried• Federal Tax Return filed in the last 2 years claiming◦ Must be incapable of selfchild; AND
support due to a mental• Affidavit of Disabilityor physical disability◦ Must be dependent upon
Note: The Affidavit of Disability can be found on:
you for support• UnifyHR site under Resources: app.unifyhr.com◦ Must be claimed as a tax• UCNet: ucal.us/fmv
dependentFebruary 2022 - reviewed May 2024