Eligibility

Your Dependents will become eligible for benefits on the same date you become eligible. Your eligible Dependents include:

• Your lawful spouse, or Domestic Partner, Your natural or legally adopted children up to age 26. Legally adopted children are recognized as Dependents from the date they are placed with the Employee for adoption.
• Your stepchild up to the age of 26.
• A foster child up to the age of 26.
• Your child of any age who is incapable of supporting himself or herself because of a mental or physical handicap on the date he or she would otherwise lose coverage due to age and who remains chiefly dependent upon you for support. Written evidence of such incapacity must be furnished to the Fund Office within 31 days after your dependent attains age 26. Upon request, you must provide the Fund with evidence satisfactory to the Fund of your child’s continued disability.

NOTE: If you have a spouse, Domestic Partner or covered Dependent who is working and eligible for group coverage in a separate plan through his or her employer, but decides not to enroll in the other plan, the Plan may treat the Dependent as if he or she was receiving coverage from the other plan. Specifically, if your Dependent(s) chooses not to participate, and the employee contribution required by the other plan is less than $65 per month, the Fund will pay benefits as though your spouse, Domestic Partner, and Dependent had enrolled in the other group coverage with benefits identical to the Fund’s PPO Plan. See “Coordination of Benefits” for more details of this requirement.

New Dependents

If you acquire a new Dependent (for example, you get married, have a baby, or adopt a child, or register your Domestic Partnership), you must notify the Fund Office and enroll your new Dependent within thirty (30) days. Failure to do so will delay your Dependent’s coverage until your next rolling enrollment date, regardless of whether you are covered under the PPO Medical Plan or the Kaiser HMO Plan.

New Dependents enrolled within thirty (30) days are covered as of the date of marriage or birth, or in the case of adoption, the date the child is placed with the Employee for adoption.

Your Dependents must be enrolled to receive benefits.

Domestic Partner means same-sex and opposite-sex couples registered with any state or local government agency authorized to perform such registrations. To establish eligibility for your domestic partner, the Plan requires proof of registration of Domestic Partnership in the form of a valid Certificate of Registration of Domestic Partnership from a state or local government. There are no requirements for proof of relationship or waiting periods that are not also applied to married couples.

Once you establish your Domestic Partner’s eligibility, he or she will be treated as a legal spouse under the Plan, to the extent permitted by law, and your Domestic Partner’s children will be treated the same as stepchildren under the Plan.

After establishing a Domestic Partnership, you and your Domestic Partner must notify the Fund Office if either of you terminate the Domestic Partnership, or if either of you file a Notice of Termination of a Domestic Partnership with a state or local government.

Tax Consequences of Domestic Partner Eligibility

Federal tax laws require the Fund to determine how much of the monthly Employer Custodial Care to the Fund is attributable to the coverage of your Domestic Partner and to report that amount as additional taxable income paid to you. This additional taxable income applies unless you can show that for purposes of your federal income tax returns you have primary responsibility for your Domestic Partner’s living expenses. In other words, if your Domestic Partner has a job or supports himself or herself through his or her own work, you will have to pay the employee payroll taxes each quarter on part of the monthly Employer Contribution paid on your behalf. The amount of the monthly Employer Contribution deemed “income” will be calculated by the Fund once a year and is likely to be 40% or more of the monthly Employer Contribution.

If your Domestic Partner is not your “dependent” for federal income tax purposes, the “additional income” described above is also subject to employer withholding. For your Domestic Partner to be covered your employer must agree to pay the employer payroll taxes on the value of your Domestic Partner coverage. If you want to enroll a Domestic Partner, call the Fund Office. If your Domestic Partner is not your dependent, ask for a notice indicating the “fair market value” of the Domestic Partner coverage as well as a form for your employer to fill out indicating either that it will pay its share of the payroll taxes for your Domestic Partner coverage or affirm that it does not consider your Domestic Partner’s benefits as taxable income. If your Domestic Partner is also your dependent, you will be asked to provide supporting documentation and/or complete an attestation form certifying that you have primary responsibility for your Domestic Partner’s living expenses.

If a medical child support order is submitted to the Plan providing for the coverage of a child as a Dependent, the Fund will review the order to determine whether it satisfies the legal requirements for a QMCSO. If the Fund approves the QMCSO, the child will be enrolled as your Dependent. If the order was issued in the form of a “National Medical Support Notice” and is subsequently determined to be qualified, your child will automatically be enrolled in the Plan option in which you are enrolled, unless the Notice specifies a particular option chosen by a state child enforcement agency, in which case both you and your child will be enrolled in that option.

Your coverage under the Plan will terminate upon the earliest of:

• the date the Plan terminates
• the last day of the month for which your Employer has made Contributions to the Plan on your behalf
• the date your Employer withdraws from the Plan and ceases to be a Contributing Employer
• the 32nd day after your full-time military service begins; or
• the last day of the month during which you retire or begin receiving a pension.

Your Dependents’ coverage ends on the earliest of:

• the day your coverage ends
• the last day of the month during which your Dependent ceases to qualify as a Dependent; in the case of your spouse or step children—copy of divorce decree required.
• the date of your death
• the last day of the month during which you discontinue your Dependent’s coverage
• the day your Dependent enters full-time military service; or
• the date on which the Plan terminates.

IF YOU FAIL TO NOTIFY THE FUND OFFICE OF A DEPENDENT’S LOSS OF DEPENDENT STATUS, YOU OR YOUR DEPENDENT MAY BE RESPONSIBLE FOR THE CHARGES SUBMITTED BY YOUR FORMER DEPENDENT. FOR EXAMPLE, IF YOU DIVORCE YOUR SPOUSE AND DO NOT NOTIFY THE FUND OFFICE WITHIN 60 DAYS OF THE DIVORCE, BOTH YOU AND YOUR FORMER SPOUSE MAY BE HELD RESPONSIBLE FOR ANY BENEFITS THAT WERE PAID BY THE PLAN AFTER YOUR DIVORCE.

Exceptions to Termination of Coverage