Policy 3.78

Dependents for Purposes of Health Insurance Coverage

1. Purpose. This policy is to grant District employees an option to cover their legal dependents and registered domestic partners in medical, dental and vision plans offered to eligible employees of the District. The purpose of this policy is to define and clarify the terms "dependent" as well as specify the documents required to support such dependent relationship to the District.

2. Definitions - The following terms are defined as follows:

   1. Eligible Employee means a regular employee who is employed in a paid status of four or more hours per day, unless otherwise provided for in a collective bargaining agreement.

   2. Covered Employee means an eligible employee enrolled in a District health plan.

   3. Eligible Dependent includes the following individuals, subject to relevant and appropriate dependent verification as required in this policy.

      1. Spouse is a person to whom the covered employee is married, and that marriage is recognized by the laws of the State of Florida.

      2. Qualifying Child is an unmarried dependent child of the covered employee or employee's spouse who is under the age of 19 years old, for whom the covered employee or employee spouse provides primary support and maintenance and claims as a dependent for tax purposes, and is

         1. A child by birth or adoption;

         2. A stepchild or registered domestic partner's child, residing full-time in the same household of the employee;

         3. A child placed in the employee's home pending adoption by the covered employee or employee's spouse; or

         4. A child for whom the employee, or the employee's spouse, has been awarded legal guardianship or custody. The child must reside in the employee's home if the child is the legal guardian or in legal custody of the employee's spouse.

      3. Qualifying child is further defined to include;

         1. Grandchild. A grandchild of the employee who is added as a newborn, up to the maximum time period of 18 months of age, due to the unmarried parent of the grandchild being covered as an eligible dependent of the employee.

         2. Postsecondary Education Student. An unmarried dependent child of the covered employee who is registered as a full-time or part-time student at a postsecondary educational institution or vocational school may be covered through the end of the calendar year in which the child attains the age of 25 years, provided that the child is dependent upon the employee for at least 50 percent of their support and maintenance.

         3. Non-Student Overage Dependent. An unmarried, 19 to 25 year old child dependent on the covered employee for more than 50% of his or her financial support and maintenance and residing full-time in the employee's home may be covered through the end of the month in which the child turns 25.

         4. Dependent of Both Parents. An unmarried child of a divorced or legally separated covered employee may be considered the dependent of both parents for certain purposes under the Internal Revenue Code.

         5. Disabled Adult Child (Over the Age of 25). A dependent child of who is incapable of self-sustaining employment by reason of developmental disability or physical handicap; is dependent upon the covered employee for support and maintenance; and whom the covered employee or spouse claims as a dependent for IRS purposes. However, the child must have become incapacitated prior to attaining 19 years of age and while covered as a dependent under the District's health plan.

         6. Overage Child. An overage child of a covered employee that otherwise may not be eligible for coverage may be covered in a medical plan only, until the end of the calendar year in which the overage child turns 30 years of age, provided:

            1. The Child is unmarried and does not have a domestic partner or any dependents of his or her own;

            2. The child is a resident of the State of Florida or a full-time or part-time student of a postsecondary education institution or vocational school;

            3. The child is not provided coverage, nor is coverage available, as a named subscriber, insured, enrollee or covered person under any other group, blanket, or franchise health insurance policy or individual health benefits plan, or is not entitled to benefits under Title XVIII of the Social Security Act, and;

            4. The covered employee covers the costs associated with an additional and separate premium than required for other eligible dependents as provided for under the District's medical plan.

            5. The child has been continuously covered by other creditable coverage as defined under Fla. Stat. §627.6562, without a gap of more than 63 days and provides documentation of such coverage.

4. Domestic Partner, for benefit purposes, is a same-sex or opposite-sex domestic partner of a covered employee, both of whom are sharing a long-term committed relationship of indefinite duration which meets the following criteria.

   1. Are at least 18 years of age or older.

   2. Are competent to enter into a contract.

   3. Have no blood relationship that would preclude marriage under laws of the State of Florida.

   4. Are not married to or partnered with any other spouse, spouse equivalent or domestic partner.

   5. Have not had another domestic partner at anytime during the 12 months preceding this enrollment.

   6. Have entered into a domestic partner relationship voluntarily, willingly, and without reservations.

   7. Have shared the same regular and permanent residence in a committed relationship for at least one year and intend to do so indefinitely.

   8. Are jointly responsible for each other's common welfare, and share financial interdependence and mutual obligations akin to those of marriage.

   9. Have provided to the Department of Risk and Benefits Management, an affidavit of domestic partnership or a proof of registration and recording as a domestic partner in the county in which they reside, as provided in Section 5 of this policy,

3. Policy. The School Board recognizes the diversity of District employees, and understands that family circumstances may vary among individual employees. Subject to agreement with the School District's insurance carrier, it is the policy of the School Board to allow eligible employees to enroll their eligible dependents, qualifying domestic partners, and the qualifying dependent children of domestic partners on their medical, dental and vision plans.

   1. If an employee has waived his or her medical, dental, or vision coverage, the employee cannot enroll a dependent for such coverage.

   2. Verification documents required for dependents and domestic partners must be provided to the Office of Risk and Benefits Management within thirty (30) days of an employee becoming eligible for benefits, at the time of initial employment or the period of annual/open enrollment.

   3. The value of such benefits may be considered taxable income to the employee, and the benefits may be available only on an after tax basis or with certain other restrictions due to State and/or Federal regulations.

4. Dependent Verification Documentation Requirements. Documentation will be required upon enrollment for coverage, or for continued coverage, to substantiate that an individual meets the definitions of eligible dependents as defined in Section 2 (c) above.

   1. Spouse : A certified copy of a government-issued marriage certificate.

   2. Domestic Partner : An affidavit of domestic partnership with supporting documentation, or proof of registration of the domestic partnership, as required by Section 5 of this policy.

   3. Dependent Child.

      1. If younger than age 19, an original or certified copy of a government-issued birth certificate listing the names of parents; legal adoption papers as the final adoption papers or confirmation of placement for adoption purposes; or a copy of the guardianship, custody or foster care papers issued by a court.

      2. If ages 19-25: An original or certified copy of a government-issued birth certificate, legal guardianship or legal custody court documents listing the covered employee as legal guardian or granting the covered employee legal custody; a copy of the child's driver's license or state issued identification card; financial and residency affidavit; copy of the child's or parent's current IRS Tax Return; and a copy of the child's current school schedule. Additionally, if the child is not enrolled in school as a student, the following is required: a copy of the child's driver's license or state issued identification card; financial and residency affidavit; and a copy of the child's or covered employee's current IRS Tax Return. In the event the child is enrolled in school as a student the following is required: a government-issued original or certified copy of the child's birth certificate or legal guardian court documents listing covered employee or employee's spouse as legal guardian; a copy of the child's current school schedule; a financial affidavit; and a copy of the covered employee's or divorced spouse's current IRS Tax Return.

      3. If ages 25-30 : An original or certified copy of a government-issued birth certificate or guardianship court documents listing the covered employee or employee's spouse as the parent or guardian; a copy of the child's driver's license or state issued identification; an overage dependent affidavit; and student certification indicating the full-time or part-time status as a student of a postsecondary or vocational institution or a copy of the child's current school schedule. If other coverage is terminated after the child reaches age 25, the child is not eligible to be covered under the parent's policy unless the child was continuously covered by other creditable coverage without a gap in coverage of more than 63 days, as provided by Florida law.

      4. Disabled Adult Child (Over the Age of 25): A copy of documentation from the Social Security Administration which indicates the child has been deemed disabled. Proof must be provided 30 days prior to when the child would no longer meet the eligibility age definition.

      5. Grandchildren: If age birth to 18 months, a copy of a government-issued birth certificate. A grandchild beyond 18 months requires qualification under another covered eligible dependent category as provided in Section 2 of this policy.

      6. Stepchildren: An original or certified copy of a government-issued birth certificate listing the covered employee's spouse as a parent of the stepchild and an original or certified copy of a government issued marriage certificate of the covered employee and spouse.

   4. Termination of Dependent Coverage. Dependent coverage is subject to termination due to the failure of the covered employee to provide the required information and/or documentation within thirty (30) days of the initial eligibility or enrollment or within 60 days of a qualifying event. A qualifying event is an event as marriage, divorce, dissolution of a domestic partnership, birth or adoption of a child, death of a spouse, child or partner.

5. Domestic Partnership Verification Documentation Requirements.

   1. Registration of the Domestic Partnership. To establish a qualifying domestic partnership, an employee and his/her domestic partner must submit proof of registration and recording as a domestic partner in the county in which the employee and domestic partner reside as well as a completed Affidavit of Domestic Partnership, incorporated hereto, and may be found on the Risk and Benefits Management website. If the employee does not reside in a county providing for the registration and recording of a domestic partnership, the employee shall submit to the School District's Office of Risk and Benefit Management a completed Affidavit of Domestic Partnership, as provided herein, and such other evidentiary documentation as required in the affidavit.

   2. Termination or Dissolution of Domestic Partnership. If there is a change in the status of a qualifying domestic partnership resulting in a dissolution of the domestic partnership, a Notice of Termination of Domestic Partnership, attached and incorporated hereto, must be completed and provided to the School District's Office of Risk and Benefit Management, within 30 days of the dissolution. A copy of the Notice of Termination of Domestic Partnership, which is incorporated herein by reference, may be found on the Risk and Benefits Management website. A twelve-month waiting period from the date the Termination Statement of Domestic Partnership is signed and returned to the Office of Risk and Benefits Management must elapse before an employee can enroll a new domestic partner. The termination shall become effective on the date of filing of the termination statement.

   3. Automatic Termination/Dissolution of Domestic Partnership. A registered domestic partnership shall automatically terminate upon the marriage of one of the registered domestic partners, the death of one of the registered domestic partners, or upon one of the registered domestic partners entering into a civil union with someone other than his or her registered domestic partner.

   4. Termination of Domestic Partnership Coverage. Domestic partnership coverage is subject to termination due to the failure of the covered employee to provide the required information and/or documentation within thirty (30) days of the initial eligibility or enrollment or within 60 days of a qualifying event. The supporting documentation shall be presented to the Office of Risk and Benefits Management,

   5. Coverage for Domestic Partnerships Children. Coverage for children of a domestic partnership is subject to the same enrollment and eligibility considerations as other dependent children with the added requirement that the dependent children reside in the home of the employee on a full time basis.

6. Additional Information Required. An employee will be required to provide social security numbers for each enrolled dependent. Additional paper work may be required by the provider for an applicant to obtain coverage under the District's medical, dental or vision plans.