Dependent Verification
     

• Download a Dependent Verification Requirements flyer which lists the allowable documents you can submit to verify your dependent’s eligibility to be covered under United healthcare plans. If you cover a domestic partner or a declaration of common law marriage an Affidavit of Domestic Partnership is required. If you remove a domestic partner or a declaration of common law marriage an Affidavit of Termination of Domestic Partnership is required.
  Completed verification documents can be submitted with a cover page that includes your name, associate ID, last four digits of your SSN and daytime telephone number. 
• Verification of your dependents MUST be received within 60 days of the effective date of coverage.  If the verification is not received, your dependents will not be covered on the plan. 
• You can: 
  • Fax your documentation to (806) 791-6341; please include your Team Member number and name.
  • Email totalbenefits@unitedtexas.com; please include your Team Member number and name. 

Working Spouse Surcharge

• If you are covering a spouse on the Medical Plan you must complete the Working Spouse Surcharge Form.  No spouse will be eligible or be enrolled in a Medical Plan until this form is completed and returned. This form must be renewed each Annual Enrollment period. 
  • Working Spouse Surcharge Form
  • Fax your documentation to (806) 791-6341; please include your Team Member number and name.
  • Email totalbenefits@unitedtexas.com; please include your Team Member number and name.