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Student Health and Counseling Services

Dependent Health Insurance Plan
For dependents of undergraduate, graduate
and professional students
(Academic Year: Fall 2011 - Summer 2012)

Undergraduate, graduate and professional students who are enrolled in UC SHIP have the option to enroll eligible dependents in a voluntary plan. The plan provides medical insurance and the option to purchase dental/vision benefits.

Enrollment in the dependent plan is managed by Wells Fargo (on behalf of Anthem Blue Cross) and the cost of insurance (premiums) for dependents is paid directly to Wells Fargo. Insurance Services DOES NOT manage the enrollment or collect payments for the dependent plan. For dependent plan enrollment questions, please contact Wells Fargo customer service at 1.800.853.5899

Dependent Plan Benefits

Medical

Dental

Vision

Enrollment Forms: 2011-2012 Academic Year

Coverage for eligible dependents will not be effective prior to that of the insured student, or extend beyond that of the insured student. Dependent enrollment/re-enrollment in the dependent plan is not automatic. Eligible dependents must be re-enrolled each subsequent quarter/semester in order to continue coverage under the dependent plan.

Enrollment forms can be found by clicking on the following links and include information about coverage dates, enrollment deadlines, and costs of insurance:

For dependent plan enrollment questions, please contact Wells Fargo customer service at 1.800.853.5899

Dependent Eligibility & Documentation

Eligibility

Undergraduate, Graduate and professional students who are enrolled in UC SHIP have the option to enroll eligible dependents in a voluntary plan. The following types of dependents may enroll:

  • Spouse: Legally married spouse of the student.
  • Same-Sex Domestic Partner
  • Child: The student’s unmarried
  • Natural child under the age of 26
  • Stepchild: A stepchild under the age of 26 is a dependent on the date the student marries the child's parent
  • Adopted child under the age of 26, including a child placed with the student for the purpose of adoption, from the moment of placement as certified by the agency making the placement
  • Foster Child: A foster child under the age of 18 is a dependent from the moment of placement with the student as certified by the agency making the placement

NOTE: If both student parents are covered under UC SHIP, their children may be covered as the dependents of either student, but not both.

For dependent plan enrollment questions, please contact Wells Fargo customer service at 1.800.853.5899

Documentation

Students are required to provide proof of dependent status when enrolling their dependents in the plan. The following documents will be accepted:

  • For spouse, a marriage certificate
  • For same-sex domestic partner, a Declaration of Domestic Partnership issued by the State of California, or of same-sex legal union other than marriage formed in another jurisdiction, or a completed Declaration of Domestic Partnership form issued by the University
  • University of California Forms for Graduate Students:
  • For natural child, a birth certificate showing the student is the parent of the child
  • For stepchild, a birth certificate, and a marriage certificate showing that one of the parents listed on the birth certificate is married to the student
  • For adopted or foster child, documentation from the placement agency showing that the student has the legal right to control the child’s health care

For dependent plan enrollment questions, please contact Wells Fargo customer service at 1.800.853.5899