Required Documents
Member date of birth verification: Provide a legible copy of your birth certificate, driver's license or passport, a court order, or immigration and/or naturalization documents.
Beneficiary date of birth verification: Provide a legible copy of the beneficiary's birth certificate, driver's license or passport, a court order, or immigration and/or naturalization documents.
Dependent date of birth verification: Provide a legible copy of the dependent's birth certificate, driver's license or passport, a court order, or immigration and/or naturalization documents.
Name change verification due to marriage/divorce: Provide a legible copy of your Social Security card, marriage certificate, or divorce decree.
Proof of Medicare A and B for member and/or dependents: Provide a copy of your Medicare card with effective dates of coverage or a letter from Medicare stating the effective dates of coverage.
Social Security statement: Provide a copy of your
Personal Earnings Benefit Estimate Statement (PEBES).
Direct deposit information: Provide a copy of a voided personal check (checking accounts) or a letter from your financial institution (savings accounts).
Funeral home license: Provide a copy of the funeral home license if the member chooses to name the funeral home as a beneficiary of the death benefit.
Designation of spouse and/or dependent child for health insurance contributions: Form 6256. (Only dependents who meet the definition of a "dependent child" as defined by Kentucky Revised Statute 16.505(17) are eligible to receive health insurance contributions.)