Dependent Eligibility
* Spouse
Eligible Dependents Documentation Required for Enrollment Due Dates
* NOTE : Spouses offered coverage through their own employer ( other than the City ) are not eligible for coverage on either City medical plan .
• Marriage License ,
• Most Recent Joint Tax Return , or
• Informal Marriage Form ( recognized by court )
30 days
Child / Stepchild • Birth Certificate 30 days Other Dependent Child Under 26 Years Old
• Court order for Guardianship or Conservatorship signed by a Judge
30 days
Adopted Child • Adoption Documents & Birth Certificate 30 days Child Placed for Adoption • Placement Documents & Birth Certificate 30 days
Qualified Medical Support Order • Notification from State Attorney General As directed by AG ’ s Order
Other Medical Support Order directed to the City of Arlington
Child incapable of self-sustaining employment due to a mental or physical disability when the child is enrolled in the City medical plan the day before age 26 .
• Copy of Court Order to City of Arlington
• Attending Physician Statement
NOTE : Dependents are only eligible for City plans until age 26 .
30 days
30 days
Annual Audit of Selected Employees
Enrollment for ‘ future life events ’ is not allowed . Example : Marriages that have not yet taken place and / or children that have not yet been born are not eligible for enrollment until the date of the actual life event ( marriage / birth , etc .) Contact Human Resources for additional information .
Annually , the City may conduct an audit requiring selected employees to provide documentation proving eligibility of covered dependents . This process is intended to confirm employees have only enrolled eligible family members . Any information that is false and / or inaccurate or enrolling dependents that do not meet eligibility guidelines is a material misrepresentation . This conduct may result in discipline up to and including termination of employment , personal liability for benefits received and / or criminal prosecution . Additional consequences may apply .
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