Notification of a Deceased Covered California Member

Submit a copy of one of the following documents.

  1. A written statement that the individual is not deceased. The statement must include:
    • Statement from the individual that he or she is not deceased.
    • Statement from the individual that the information provided is true and correct to the best of his or her knowledge.
    • The date and the signature of the individual who was incorrectly identified as being deceased.
  2. If a consumer is deceased, please notify Covered California. The following documents are accepted as proof of death:
    • Copy of Death Certificate.
    • Bureau of Vital Statistics records.
    • Widow or survivor’s benefits on the deceased individual’s Social Security number (SSN).
    • Veterans Administration or military service records.
    • Hospital or medical records.
    • Signed funeral director’s statement.
    • Indian census records.
    • Newspaper death notice (obituary).
    • Insurance company records.
    • Social Security records.
    • Institutional records.
    • Veterans Administration death payment correspondence.
    • Insurance company death settlement correspondence.
    • Minister or clergy statement.
    • Proof of executor.
    • Proof of estate.
    • Probate court order (or Letter of Testamentary).
    • Copy of a recorded Affidavit of Death of a Joint Tenant.
    • Copy of a notarized Affidavit for Collection of Personal Property.

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