• Eligible Dependents
• Dependent Verification Documentation Chart
• Affidavit of Adult Child (Certification of Over-age Dependent)
• Disabled Adult Dependent Certification Form
• Working Spouse Waiver Form
• Instructions on how to request your tax return transcript

The following dependents are eligible for medical, dental and vision coverage:

• Legally married spouse (spousal waiver may apply)
• Children up to age 26 (your natural child, legally adopted child, stepchild, legal guardian or foster child)
• Overage dependent child
• Dependent children with disabilities

Click here for detailed information about who is eligible for coverage under the District’s group health plan.

You must submit the required documents by the close of business on the final date as defined below:

• New Hire/Newly Benefit Eligible - Documents due within 30 days of benefits effective date.
• Mid-year Qualifying Event - Documents due within 30 days of enrollment
• Open Enrollment - Documents due November 8, 2024

You are required to notify CBIZ within 30 days of a change in your marital status or a change in dependent’s status. Failure to notify CBIZ may result in you receiving a benefit under the group health plan that your covered dependents are not eligible to receive. Should this occur you will be required to repay the Board any premiums due or benefits received that you were not entitled to receive.

You may request a copy of your tax return transcript from the IRS at www.irs.gov/individuals/get-transcript or by calling the IRS at (800) 908-9946.

Click here for step-by-step instructions on how to request an online copy of your tax return transcript.

Submitting Documentation:

• You will upload the documents directly to the CBIZ platform when you are enrolling in benefits.

Working Spouse Waiver Form

If your spouse is employed and has access to medical coverage through his/her employer, they are no longer eligible for coverage under Pasco County Schools’ group medical plan.

If your spouse does not work, works only part-time, is not eligible for coverage or has lost coverage as an active employee but has been offered cobra, the spousal exclusion does not apply. If your spouse is covered by Medicare, the exclusion does not apply.

If your spouse experiences a qualifying life event (loss of job or loss of coverage, etc.) during the year, he or she can be added to your medical plan within 30 days of the qualifying event.

If you designate your spouse as a dependent to be enrolled in Pasco County Schools’ group medical plan, you will need to submit a completed spousal waiver form verifying your spouse’s ineligibility for coverage under their employer’s medical plan.

If you do not complete and return the waiver form, your inaction will deem your spouse ineligible for coverage.
If deemed ineligible for coverage, your spouse will be removed from Pasco County Schools’ group medical plan.

The “Working Spouse Waiver” does not affect your option to enroll your spouse in voluntary benefits such as dental, vision or other applicable voluntary benefits, as long as you provide the required dependent verification
documents.

Policy exemption:

• If you and your spouse are both employed by Pasco County Schools, you are not subject to this policy.
• If you are enrolling in family coverage(employee plus spouse and children), you are not subject to this policy.