Dependent Eligibility / Supporting Documentation

If you are adding dependent(s) to your State health plans, you must scan and submit the following documentation either via the Upload Documents function in OnlinEnroll or via fax to the Office of Employee Benefits at (401) 574-9281.

  • If uploading to OnlinEnroll – The supported formats are: txt, pdf, rtf, ppt, pptx, xls, xlsx, doc, docx. The maximum file size is 4096 KB.

Anyone not shown in the table below is ineligible to be covered as a dependent.

Dependent Relation Supporting Documentation Notes / Exceptions
Spouse A copy of the marriage certificate
  • Dual State-employed spouses – Where two State-employed spouses were both hired on or after June 29, 2014 and are both covered under one family plan, the co-share shall be based on the income of the higher earner as determined by the annualized total rate of pay. Further, the spouse that does not pay the co-share is ineligible to receive the waiver opt-out payment.
  • Ex-spouse – If your divorce was finalized after January 1, 2014, your ex-spouse is not eligible for State health coverage.
Domestic partner At least TWO of the following four items (items in #3 counts as one):
  1. Domestic Partnership Agreement or a Relationship Contract
  2. Joint mortgage or joint ownership of primary residence
  3. TWO of the following four items proving financial interdependency:
    1. Joint ownership of vehicle
    2. Joint checking account
    3. Joint credit account
    4. Joint lease
  4. Employee's will, retirement contract, or life insurance showing domestic partner as beneficiary
  • Imputed Income – If your domestic partner does not meet the definition of a dependent pursuant to Internal Revenue Code Section 152 (as modified by Section 105(b)), federal law requires that the fair market value of any State health coverage extended to your domestic partner must be imputed to you as income on your paycheck and must be reflected on the W-2 issued to you by the State of Rhode Island. For example, if you were a 26 pay-period employee covering your domestic partner under the State medical, dental and vision plans, your imputed income would be around $200 per pay period and be deducted from each paycheck.
  • Changes to domestic partnership – If you get married, or if your domestic partnership ends, it is YOUR responsibility to inform the Office of Employee Benefits in writing immediately. Your failure to do so will prevent you from obtaining refunds of co-shares paid and/or imputed income tax withheld. The Office of Employee Benefits will not coordinate such refunds if it is not notified within 31 days of the date of the change.
  • Birth – A copy of the birth certificate (We understand that this takes time. Please add your newborn as a dependent within 31 days of date of birth and follow up with the birth certificate once received; same for the social security number.)
  • Adoption – A copy of the adoption decree
  • Legal guardianship – A copy of the court decree awarding legal guardianship
  • Step-children – Step-children are eligible.
  • Foster children / grandchildren – Foster children and grandchildren are not eligible unless the employee adopts or has legal guardianship over them.
  • Handicapped / disabled children – Handicapped / disabled children are eligible beyond their 26th birthday if their physician certifies them as handicapped / disabled and if they are receiving Social Security benefits. Please contact OEB for additional information or assistance.
  • Children of domestic partner – Children of a domestic partner are not eligible unless the employee adopts them or marries their parent.