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Required Documentation

Required Documentation

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 immediately after contacting MI HR* to enroll.

Benefits Open Enrollment (BOE): Any newly-elected benefits or changes made during BOE will go into effect on January 1 of the following year.

CY2025 Benefits Open Enrollment

Copies of all supporting documentation for any newly added individuals to your benefits must be emailed, faxed, or mailed to the MI HR Service Center* by November 8, 2024. Documentation not provided by this date will result in the individual(s) not being added to your benefits.

Qualifying Life Events

To add or change eligible dependents due to a qualifying 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. All supporting documentation must also be provided within 31 days of the qualifying life event.

The State of Michigan Vital Records Office can provide certified copies of birth, death, marriage, divorce, and affidavit of parentage records. For more information, visit www.mi.gov/vitalrecords or call 517-335-8666.

*Auditor General and Judicial employees should contact their HR office instead of the MI HR Service Center.

Health, Dental, Vision, and Dependent Life Insurance

    • Adoption Papers or a notarized sworn statement with the date of placement
    • Birth Certificate (must be county issued; hospital verifications not accepted)
    • Court Document placing the child in the employee’s home for foster care
    • Birth Certificate (must be county issued; hospital verifications are not accepted)
    • Documentation proving you provide at least 50% support to the parent of the grandchild (e.g., copy of most recent federal 1040 form filed showing the grandchild’s parent was claimed as a dependent)
    • Student Verification of Eligibility Form (CS-1830)  
    • School Records proving the grandchild's parent is regularly attending an accredited educational institution (e.g., class schedule, transcript)

    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.

    • Birth Certificate (must be county issued; hospital verifications not accepted)
    • Verification Documentation that the child’s condition was confirmed by the insurance carrier before the child reached the usual age limit for coverage
    • Court-Ordered Letters of Guardianship
    • Document Detailing Loss of Coverage from employer or insurance carrier on their letterhead, specifying the benefits for which coverage has been lost (e.g., health, vision, dental), last date of coverage, and individuals covered
    • Marriage Certificate
    • Birth Certificate (must be county issued; hospital verifications not accepted)
    • Marriage Certificate

Health Only

    • 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)

  • AND

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

    • Birth Certificate (must be county issued; hospital verifications not accepted)
    • Adoption Papers or sworn statement with the date of placement

    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

    • Document Detailing Gain of Coverage from employer or insurance carrier on their letterhead, specifying the benefits for which coverage has been gained (e.g., health, vision, dental), date coverage began, and individuals covered
    • Death Certificate
    • Divorce Decree (first and last page signed/dated by judge and stamped by the court)

Contact

If you have questions on documentation requirements,
contact the MI HR Service Center at: 877-766-6447
Email Documents: MCSC-MIHR-Docs@michigan.gov
Fax Documents: 517-241-5892
Mail Documents: MI HR Service Center, P.O. Box 30002, Lansing, MI 48909
Note: Auditor General and Judicial must submit the required documentation to their HR office.