Add a Family Member or Dependent

Overview of Process

The following steps outline the process to Add a Family Member or Dependent (assuming the dependent is eligible for coverage and you submit the required documentation.)

  • Complete and submit the Add a Family Member or Dependent form for each of your dependents you would like enroll in benefits.
  • Submit required documentation, i.e., birth certificate, marriage certificate, to MSU Human Resources.
  • MSU Human Resources will review your form and documentation and individually approve your dependents to add them to your personnel record.
  • You must complete benefit enrollment, adding your dependent(s) for coverage within the standard time period (typically 30 days.)

Add Dependent due to Adoption/Legal Guardianship

Employee Details is a view-only display of the information we have in your personnel record.

  1. Click on the drop-down list and select Adopt/Legal Guardian.
  2. Enter the date of the legally-finalized adoption or guardianship.
  3. Click on the drop-down list and select the dependent type involved in this adoption/legal guardianship.
  4. Enter the dependent’s name details, including suffix when applicable, in the name fields. (Last Name is a required value.)
  5. Enter the dependent’s date of birth, Social Security Number/ITIN and choose the Gender from the drop-down list. (Date of Birth and gender are required values.)
  6. If dependent resides at a different address than you, click to check the box.
      1. Complete the address information fields.
  7. Click on to choose Yes or No to answer whether the Family Member/Dependent is currently on Medicare.
  8. Click to check the box if the Family Member/Dependent is disabled and the link for the Dependent Disability Certification form is available.
    1. Click on the Dependent Disability Certification form to open and complete the form.
    2. Save the form to attach at a later step or to provide in paper form to MSU Human Resources.
  9. Click Next to continue to next screen.
  10. Click on the drop-down list and choose the Attachment type to attach required documentation.
  11. Click on Choose File button to browse to your documentation and click Open.
  12. Click on Upload button and the attachment appears in the list of attachments above.
  13. Repeat steps 10-12 for additional required documentation for this dependent.
  14. Enter comments in the New Comments field, if desired.
  15. Click Next to continue to next screen.
  16. Review the information in the Summary screen and make changes if needed.
  17. Click on Check to validate the information you’ve entered in the form.
  18. Click Send to submit this form to MSU Human Resources.
      1. Click on Save Draft if you need to save and return to the form later.
      2. Click on Generate PDF to create a PDF that you can save or print.

When complete, click Home (house), log out, or search for another application.

Add Dependent due to Birth

Employee Details is a view-only display of the information we have in your personnel record.

  1. Click on the drop-down list and select Birth.
  2. Enter Date of Birth.
  3. Click on the drop-down list and select the dependent type to be added.
  4. Enter the dependent’s name details, including suffix when applicable, in the name fields. (Last Name is a required value.)
  5. Enter the dependent’s Social Security Number/ITIN and choose the Gender from the drop-down list. (Date of Birth and gender are required values.)
  6. If dependent resides at a different address than you, click to check the box.
      1. Complete the address information fields.
  7. Click on to choose Yes or No to answer whether the Family Member/Dependent is currently on Medicare.
  8. Click to check the box if the Family Member/Dependent is disabled and the link for the Dependent Disability Certification form is available.
    1. Click on the Dependent Disability Certification form to open and complete the form.
    2. Save the form to attach at a later step or to provide in paper form to MSU Human Resources.
  9. Click Next to continue to next screen.
  10. Click on the drop-down list and choose the Attachment type to attach required documentation.
  11. Click on Choose File button to browse to your documentation and click Open.
  12. Click on Upload button and the attachment appears in the list of attachments above.
  13. Repeat steps 10-12 for additional required documentation for this dependent.
  14. Enter comments in the New Comments field, if desired.
  15. Click Next to continue to next screen.
  16. Review the information in the Summary screen and make changes if needed.
  17. Click on Check to validate the information you’ve entered in the form.
  18. Click Send to submit this form to MSU Human Resources.
      1. Click on Save Draft if you need to save and return to the form later.
      2. Click on Generate PDF to create a PDF that you can save or print.

When complete, click Home (house), log out, or search for another application.

Add Dependent due to Divorce

Employee Details is a view-only display of the information we have in your personnel record.

  1. Click on the drop-down list and select Divorce.
  2. Enter Date of Divorce.
  3. Click on the drop-down list and select the dependent type to be added.
  4. Enter the dependent’s name details, including suffix when applicable, in the name fields. (Last Name is a required value.)
  5. Enter the dependent’s date of birth, Social Security Number/ITIN and choose the Gender from the drop-down list. (Date of Birth and gender are required values.)
  6. If dependent resides at a different address than you, click to check the box.
      1. Complete the address information fields.
  7. Click on to choose Yes or No to answer whether the Family Member/Dependent is currently on Medicare.
  8. Click to check the box if the Family Member/Dependent is disabled and the link for the Dependent Disability Certification form is available.
    1. Click on the Dependent Disability Certification form to open and complete the form.
    2. Save the form to attach at a later step or to provide in paper form to MSU Human Resources.
  9. Click Next to continue to next screen.
  10. Click on the drop-down list and choose the Attachment type to attach required documentation.
  11. Click on Choose File button to browse to your documentation and click Open.
  12. Click on Upload button and the attachment appears in the list of attachments above.
  13. Repeat steps 10-12 for additional required documentation for this dependent.
  14. Enter comments in the New Comments field, if desired.
  15. Click Next to continue to next screen.
  16. Review the information in the Summary screen and make changes if needed.
  17. Click on Check to validate the information you’ve entered in the form.
  18. Click Send to submit this form to MSU Human Resources.
      1. Click on Save Draft if you need to save and return to the form later.
      2. Click on Generate PDF to create a PDF that you can save or print.

When complete, click Home (house), log out, or search for another application.

Add Dependent due to New Hire/Rehire

Employee Details is a view-only display of the information we have in your personnel record.

  1. Click on the drop-down list and select New Hire/Rehire.
  2. Click on the drop-down list and select the dependent type to be added.
  3. Enter the dependent’s name details, including suffix when applicable, in the name fields. (Last Name is a required value.)
  4. Enter the dependent’s date of birth, Social Security Number/ITIN and choose the Gender from the drop-down list. (Date of Birth and gender are required values.)
  5. If dependent resides at a different address than you, click to check the box.
      1. Complete the address information fields.
  6. Click on to choose Yes or No to answer whether the Family Member/Dependent is currently on Medicare.
  7. Click to check the box if the Family Member/Dependent is disabled and the link for the Dependent Disability Certification form is available.
    1. Click on the Dependent Disability Certification form to open and complete the form.
    2. Save the form to attach at a later step or to provide in paper form to MSU Human Resources.
  8. Click Next to continue to next screen.
  9. Click on the drop-down list and choose the Attachment type to attach required documentation.
  10. Click on Choose File button to browse to your documentation and click Open.
  11. Click on Upload button and the attachment appears in the list of attachments above.
  12. Repeat steps 9-11 for additional required documentation for this dependent.
  13. Enter comments in the New Comments field, if desired.
  14. Click Next to continue to next screen.
  15. Review the information in the Summary screen and make changes if needed.
  16. Click on Check to validate the information you’ve entered in the form.
  17. Click Send to submit this form to MSU Human Resources.
      1. Click on Save Draft if you need to save and return to the form later.
      2. Click on Generate PDF to create a PDF that you can save or print. 

When complete, click Home (house), log out, or search for another application.

Add Dependent due to Loss of Previous Coverage

Employee Details is a view-only display of the information we have in your personnel record.

  1. Click on the drop-down list and select Loss of Pre Coverage.
  2. Enter end date of previous coverage.
  3. Click on the drop-down list and select the dependent type to be added.
  4. Enter the dependent’s name details, including suffix when applicable, in the name fields. (Last Name is a required value.)
  5. Enter the dependent’s date of birth, Social Security Number/ITIN and choose the Gender from the drop-down list. (Date of Birth and gender are required values.)
  6. If dependent resides at a different address than you, click to check the box.
      1. Complete the address information fields.
  7. Click on to choose Yes or No to answer whether the Family Member/Dependent is currently on Medicare.
  8. Click to check the box if the Family Member/Dependent is disabled and the link for the Dependent Disability Certification form is available.
    1. Click on the Dependent Disability Certification form to open and complete the form.
    2. Save the form to attach at a later step or to provide in paper form to MSU Human Resources.
  9. Click Next to continue to next screen.
  10. Click on the drop-down list and choose the Attachment type to attach required documentation.
  11. Click on Choose File button to browse to your documentation and click Open.
  12. Click on Upload button and the attachment appears in the list of attachments above.
  13. Repeat steps 10-12 for additional required documentation for this dependent.
  14. Enter comments in the New Comments field, if desired.
  15. Click Next to continue to next screen.
  16. Review the information in the Summary screen and make changes if needed.
  17. Click on Check to validate the information you’ve entered in the form.
  18. Click Send to submit this form to MSU Human Resources.
      1. Click on Save Draft if you need to save and return to the form later.
      2. Click on Generate PDF to create a PDF that you can save or print.

When complete, click Home (house), log out, or search for another application.

Add Dependent due to Marriage

Employee Details is a view-only display of the information we have in your personnel record.

  1. Click on the drop-down list and select Marriage.
  2. Enter Date of Legal Marriage.
  3. Click on the drop-down list and select the dependent type to be added.
  4. Enter the dependent’s name details, including suffix when applicable, in the name fields. (Last Name is a required value.)
  5. Enter the dependent’s date of birth, Social Security Number/ITIN and choose the Gender from the drop-down list. (Date of Birth and gender are required values.)
  6. If dependent resides at a different address than you, click to check the box.
      1. Complete the address information fields.
  7. Click on to choose Yes or No to answer whether the Family Member/Dependent is currently on Medicare.
      1. If Yes, enter the Medicare Claim Number, Part A Enrollment Date, Part B Enrollment Date and Part D Enrollment Date. (Medicare Claim number, Part A and Part B enrollment dates are required.)
  8. {This step optionally appears for some dependents.} Click to check the box if the Family Member/Dependent is disabled and the link for the Dependent Disability Certification form is available.
    1. Click on the Dependent Disability Certification form to open and complete the form.
    2. Save the form to attach at a later step or to provide in paper form to MSU Human Resources.
  9. Click Next to continue to next screen.
  10. Click on the drop-down list and choose the Attachment type to attach required documentation.
  11. Click on Choose File button to browse to your documentation and click Open.
  12. Click on Upload button and the attachment appears in the list of attachments above.
  13. Repeat steps 10-12 for additional required documentation for this dependent.
  14. Enter comments in the New Comments field, if desired.
  15. Click Next to continue to next screen.
  16. Review the information in the Summary screen and make changes if needed.
  17. Click on Check to validate the information you’ve entered in the form.
  18. Click Send to submit this form to MSU Human Resources.
      1. Click on Save Draft if you need to save and return to the form later.
      2. Click on Generate PDF to create a PDF that you can save or print.

When complete, click Home (house), log out, or search for another application.

Add Dependent due to Newly Eligible for Benefits

Employee Details is a view-only display of the information we have in your personnel record.

  1. Click on the drop-down list and select Newly Eligible.
  2. Click on the drop-down list and select the dependent type to be added.
  3. Enter the dependent’s name details, including suffix when applicable, in the name fields. (Last Name is a required value.)
  4. Enter the dependent’s date of birth, Social Security Number/ITIN and choose the Gender from the drop-down list. (Date of Birth and gender are required values.)
  5. If dependent resides at a different address than you, click to check the box.
      1. Complete the address information fields.
  6. Click on to choose Yes or No to answer whether the Family Member/Dependent is currently on Medicare.
      1. If Yes, enter the Medicare Claim Number, Part A Enrollment Date, Part B Enrollment Date and Part D Enrollment Date. (Medicare Claim number, Part A and Part B enrollment dates are required.)
  7. {This step optionally appears for some dependents.} Click to check the box if the Family Member/Dependent is disabled and the link for the Dependent Disability Certification form is available.
    1. Click on the Dependent Disability Certification form to open and complete the form.
    2. Save the form to attach at a later step or to provide in paper form to MSU Human Resources.
  8. Click Next to continue to next screen.
  9. Click on the drop-down list and choose the Attachment type to attach required documentation.
  10. Click on Choose File button to browse to your documentation and click Open.
  11. Click on Upload button and the attachment appears in the list of attachments above.
  12. Repeat steps 9-11 for additional required documentation for this dependent.
  13. Enter comments in the New Comments field, if desired.
  14. Click Next to continue to next screen.
  15. Review the information in the Summary screen and make changes if needed.
  16. Click on Check to validate the information you’ve entered in the form.
  17. Click Send to submit this form to MSU Human Resources.
      1. Click on Save Draft if you need to save and return to the form later.
      2. Click on Generate PDF to create a PDF that you can save or print.

When complete, click Home (house), log out, or search for another application.

Add Dependent during Open Enrollment

Employee Details is a view-only display of the information we have in your personnel record.

  1. Click on the drop-down list and select Open Enrollment.
  2. Click on the drop-down list and select the dependent type to be added.
  3. Enter the dependent’s name details, including suffix when applicable, in the name fields. (Last Name is a required value.)
  4. Enter the dependent’s date of birth, Social Security Number/ITIN and choose the Gender from the drop-down list. (Date of Birth and gender are required values.)
  5. If dependent resides at a different address than you, click to check the box.
      1. Complete the address information fields.
  6. Click on to choose Yes or No to answer whether the Family Member/Dependent is currently on Medicare.
      1. If Yes, enter the Medicare Claim Number, Part A Enrollment Date, Part B Enrollment Date and Part D Enrollment Date. (Medicare Claim number, Part A and Part B enrollment dates are required.)
  7. Click to check the box if the Family Member/Dependent is disabled and the link for the Dependent Disability Certification form is available.
    1. Click on the Dependent Disability Certification form to open and complete the form.
    2. Save the form to attach at a later step or to provide in paper form to MSU Human Resources.
  8. Click Next to continue to next screen.
  9. Click on the drop-down list and choose the Attachment type to attach required documentation.
  10. Click on Choose File button to browse to your documentation and click Open.
  11. Click on Upload button and the attachment appears in the list of attachments above.
  12. Repeat steps 9-11 for additional required documentation for this dependent.
  13. Enter comments in the New Comments field, if desired.
  14. Click Next to continue to next screen.
  15. Review the information in the Summary screen and make changes if needed.
  16. Click on Check to validate the information you’ve entered in the form.
  17. Click Send to submit this form to MSU Human Resources.
      1. Click on Save Draft if you need to save and return to the form later.
      2. Click on Generate PDF to create a PDF that you can save or print.

When complete, click Home (house), log out, or search for another application.

Accessibility Tips

  • Use Browse Mode (NVDA key and spacebar) to read the first screen of this application, titled "Overview of Process."
  • After this, use Focus Mode. If a field label is not read, generally going to Browse Mode using the NVDA key and spacebar, then up and down arrow keys, will read the label.
  • At the bottom of each screen, use the combination of the Control and Home keys to return to the top. Then use the B key to go to the "Next" button.
  • When in a combo box use the up and down arrows to read the list of options.
  • Use browse mode to read check boxes.