Family Status Change

Tools and Resources



DOCUMENTATION NEEDED FOR FAMILY STATUS CHANGES

The following events require documentation to be submitted to the Benefits Department within 31 days of the event: 

 

 

FAMILY STATUS CHANGE EVENT

DOCUMENTATION TO SUBMIT

Dependent loss of the state's SCHIP plan

A copy of the Certificate of Creditable Coverage or a termination letter which lists the date your coverage ended   

Judgment, Decree, or Court Order to add coverage for a dependent child

A copy of the court order awarding custody or requiring coverage 

Legally married couples with different last names

Proof of marriage such as marriage certificate or jointly filed tax return

Dependent child with a last name different than yours

A copy of the birth certificate or a court document awarding custody or requiring coverage

Beginning Same-Sex Domestic Partner Relationship

Statement of Same Sex Domestic Partnership or a civil union certificate from a state or governmental agency that recognizes civil unions.

Ending Same-Sex Domestic Partner Relationship

Complete the Same-Sex Domestic Partnership Termination form

Change of residence that is inside or outside of the plan area

A copy of your visa and/or passport that shows the date of entry or exit from the plan area

Please contact the Benefits Department at 404-727-7613 for more details.