• Required Documentation

    See Also: Dependent Eligibility Guidelines
    See Also: Employee Eligibility Guidelines

    The documents listed in the expandable sections below are acceptable proof of dependent, adult child, and OEAI eligibility for insurance coverage. Click the dependent type you wish to add to your coverage to view the required documentation. See Employee Eligibility Guidelines for more detailed eligibility information.

    Documents must be provided to the MI HR Service Center via fax or mail, or delivered in person. Contact information is provided at the bottom of this page. Legible copies are required for each type of document. Please do not provide originals; documents will not be returned.

    Benefit Effective Dates

    Newly Hired Employees: Benefits will be effective the first day of the new pay-period starting after you call the MI HR Service Center (877-766-6447) to enroll. Newly hired employees must call MI HR within 31 days of their hire date to enroll in benefits. Benefits are not effective immediately upon hire or immedately after contacting MI HR to enroll.

    Insurance Open Enrollment (IOE): Any newly-elected benefits or changes made during IOE will go into effect on the first day of the full pay-period in October (the new fiscal year).

    Insurance Open Enrollment

    Copies of documentation must be faxed (517-241-5892) or mailed to the MI HR Service Center by September 30th.

    Life Events

    To add or change eligible dependents due to a life event (e.g.: marriage, birth, divorce), call the MI HR Service Center (877-766-6447)  as soon as possible, no later than 31 days following the life event. Do not wait until you have the official documentation.

Health, Dental, Vision, and Dependent Life Insurance

  • Adopted Child
    • Legal Adoption Papers or sworn statement with the date of placement
  • Biological Child
    • Birth Certificate (hospital verifications not accepted)
  • Foster Child
    • Court Document placing the child in the employee’s home for foster care
  • Grandchild
    • Birth Certificate (hospital verifications not accepted)

    Note: For a grandchild to be eligible, the grandchild's parent must be a covered dependent AND, from 19 up to their 25th birthday, a student as well

  • Incapacitated Child
    • Birth Certificate (hospital verifications not accepted)

    • Verification Documentation that the child’s condition was provided to the insurance carrier before the child reached the usual age limit for coverage

  • Legal Guardianship
    • Court-Ordered Letters of Guardianship

  • Loss of Coverage
    • Document Detailing Loss of Coverage from employer or insurance carrier specifying the benefits for which coverage has been lost (e.g., health, vision, dental) and individuals covered

  • Spouse
    • Marriage Certificate

  • Step-Child

    Note: A step-child in which an employee's spouse is required to provide at least 50% support, and resides with you 50% of the time is eligible for health, dental, and vision coverage. A step-child is eligible for health coverage regardless of residence and support. Coverage will terminate at the end of the month in which the dependent turns 26. Once a step-child reaches the age of 19 up to their 25th birthday, refer to the appropriate student column above for instruction.

  • Student (Age 19 to 25)

Health Only

  • Adult Child (Age 19 to 25)
    • Birth Certificate (hospital verifications not accepted)

  • OEAI (Other Eligible Adult Individual)
    • OEAI Enrollment Application & Affidavit (CS-1833)

    • Joint Residency Documentation establishing shared residency for the past 12 months (e.g. bank statement, utility bill, lease agreement)

    • Proof of Age (e.g. birth certificate, passport, driver’s license, or other governmental document)

  • OEAI Dependent

    AND

    Any of the four documents below, establishing the relationship between the OEAI and the OEAI dependent(s) you wish to enroll:

    • Birth Certificate (hospital verifications not accepted)

    • Adoption Papers or sworn statement with the date of placement

    • Court Document placing the child in the employee’s home for foster care

    • Court-Ordered Letters of Guardianship

    Note: Dependent children of an OEAI may enroll in health insurance only up to their 26th birthday with a CS-1833 and the same required documentation that applies to equivalent dependent children of employees. Coverage will terminate at the end of the month in which the dependent turns 26.

Removal From Insurance

  • If you have questions on documentation requirements,
    contact the MI HR Service Center at: 877-766-6447
    Fax Documents: 517-241-5892
    Mail Documents: MI HR Service Center, P.O. Box 30002, Lansing, MI 48909
    Note:
    Legislative, Judicial, and Auditor General must submit the required documentation to their Human Resource Office.