Dependent Eligibility Verification Audit
Dependent Eligibility Verification Audit
The LAwell Program will conduct a comprehensive audit of all dependents enrolled in City-sponsored benefits in early 2026. Open Enrollment is your final opportunity to remove any ineligible dependents without penalty.
- No penalties apply if removed during Open Enrollment.
- Ineligible dependents identified later will require repayment of premiums paid by the City during the period of ineligibility.
For eligibility and next steps, see the Dependent Eligibility Verification Audit FAQ.
Submission Guidelines
General Document Submission Rules
- Copies of documents are completely acceptable.
- Originals are NOT required and should not be submitted.
- Social Security Numbers (SSNs) are not required to add a dependent (including a spouse). A dependent without an SSN is acceptable.
Birth Certificates (Adding Children)
- Issuer Requirements: The document submitted must have a stamp/seal of the governmental agency AND/OR a signature of a governmental representative (such as the County Clerk).
- Age Limit: All children added as dependents must be under age 26.
- Name Matching: Verify that the last and first name of both the employee and the child match.
- Stepchildren: For a stepchild, the first and last name of the parent on the birth certificate must match the name of the employee's spouse.
- Resolving Discrepancies: If a name is only a close match, the document can be approved if an additional piece of information (like the employee's date of birth) can be verified. If the name does not closely resemble the record, additional outreach will be required to obtain supporting identification (e.g., a driver's license).
Marriage Certificates (Adding Spouses)
- Issuer Requirements: The document must be a marriage certificate issued by a governmental agency (City, County, or State). Marriage licenses or certificates issued by a church/chapel are NOT acceptable.
- Verification Marks: The certificate must have a stamp/seal of the governmental agency AND/OR a signature of a governmental representative.
- Name Matching & Maiden Names: The first and last name of the employee and spouse must match. If a spouse kept their maiden name, this is acceptable provided the employee's date of birth on the certificate can be verified against their file.
- Resolving Discrepancies: Similar to birth certificates, close name matches can be approved if another data point (like a date of birth) is verifiable. Otherwise, supporting documentation will be required.
Exceptions Requiring City Handling
The following items cannot be processed standardly and must be returned to the City for handling:
- Foreign documents (non-United States).
- Documents submitted after the final deadline.
- Qualified Medical Child Support Order (QMSCO) documents.
- Power of Attorney (POA) documents (the City will verify and notify Secova if approved).
- Any documents that do not conform to these guidelines or appear falsified/fraudulent.
Acceptable vs. Unacceptable Documents
| Document Type | Acceptable Submissions | Unacceptable Submissions | Example |
|---|---|---|---|
| Birth Verification |
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Upload / View Image
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| Marriage Verification |
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Upload / View Image
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| Foreign Marriage |
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Upload / View Image
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Frequently Asked Questions
Dependent Eligibility Verification
What is the Dependent Eligibility Verification Audit? What do I need to do?
The LAwell Program provides benefits to eligible employees and their eligible dependents. The City will now periodically audit all dependent records to ensure they meet LAwell Program eligibility rules. A dependent may lose eligibility due to events such as divorce, termination of a domestic partnership, reaching the age limit of 26 for child dependents, or other changes.
Once the Dependent Eligibility Verification audit begins, you may be required to provide documents proving that each dependent covered under your benefits meets the LAwell eligibility rules. Common examples include:
Once the Dependent Eligibility Verification audit begins, you may be required to provide documents proving that each dependent covered under your benefits meets the LAwell eligibility rules. Common examples include:
- Marriage certificate for a spouse
- Birth certificate or adoption paperwork for a child
Why is this audit happening?
Keeping ineligible dependents in your coverage is a violation of LAwell Program rules and abuse of public funds. Removing ineligible individuals helps the City control costs and maintain compliance with LAwell Program rules.
Who is an "eligible dependent" and who is not?
Generally, your legal spouse or registered domestic partner, and your children under age 26 (including biological, step, adopted, or foster children) are eligible. Some other dependents may qualify in specific situations. For full rules and required documentation, visit KeepingLAwell.com/dependents.
What happens if I have a dependent covered on my LAwell coverage who the City says should not be covered?
When you add a dependent to your LAwell coverage, you are attesting that the dependent meets the Program’s eligibility criteria. You must also provide supporting documentation at the time of enrollment. If a dependent subsequently becomes ineligible (e.g., divorce) and you fail to remove them from LAwell coverage, you may be required to repay the cost of the premiums for the period the dependent was ineligible.
During the 2026 Open Enrollment period (October 1–31, 2025), you should remove any ineligible dependents from your coverage. If you do so at that time, no penalties will apply. The Dependent Eligibility Verification audit is anticipated to take place in the first half of 2026. If the audit identifies that an ineligible dependent still exists in your covered benefits, you will be responsible for repaying all premiums associated with that dependent for the period in which the dependent was ineligible and still enrolled into benefits.
During the 2026 Open Enrollment period (October 1–31, 2025), you should remove any ineligible dependents from your coverage. If you do so at that time, no penalties will apply. The Dependent Eligibility Verification audit is anticipated to take place in the first half of 2026. If the audit identifies that an ineligible dependent still exists in your covered benefits, you will be responsible for repaying all premiums associated with that dependent for the period in which the dependent was ineligible and still enrolled into benefits.
I don't have medical coverage with LAwell and I get Cash-in-Lieu instead. Do I have to do anything for this audit?
Yes. A new/updated Cash-In-Lieu affidavit will be required to be submitted. Employees receiving Cash-In-Lieu in 2026 will receive a notice and further instructions when the Dependent Eligibility Verification audit begins.