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NRC FORM 781 (07-2013) U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NOs. 3150-0053, 3150-0209 SBCR COMPLIANCE REVIEW PART A EXPIRES: 07/31/2016 Estimated burden per response to comply with.

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A copy of a government issued marriage certificate AND one of the following documents: A copy of the first page of the most recent federal or state tax return confirming the dependent as your spouse.

Summary. To ensure only eligible dependents of CSU employees are enrolled in employer-sponsored health coverage, California Government Code Section 22843.1 requires your employer to verify the eligibility of your dependent(s) at least once every three years.

A Dependent Eligibility Verification (DEV) is simply the process by which you verify the relationship between the participant and their dependents to ensure they should in fact be eligible for coverage. Most participants do not intentionally carry ineligible dependents, they simply do not understand plan rules.

Dependent verification protects the health plan from ineligible dependents, helping plan sponsors ensure their health plan is compliant and that benefit dollars are only being spent on participants who are eligible, keeping health care costs down for everyone.

Dependent Eligibility Verification (DEV) is the process of re-verifying the eligibility of your spouse, domestic partner, children, stepchildren, and domestic partner children (dependents) enrolled in health and/or dental benefits.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232