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UPlan Dependent Eligibility Definition

The University of Minnesota develops eligibility criteria for its employees and their dependents subject to collective bargaining agreements and compensation plans that may change during a Plan Year.

An employee is eligible to participate in the University of Minnesota UPlan Medical or Dental Program (the Plan) if he/she works at the University with an appointment that is at least 50 percent time and lasts at least three months.

The University contributes a significant portion of the cost of medical or dental benefits for an employee whose appointment is 75 percent time or greater. An employee whose appointment is between 50 percent to 74 percent time is eligible to participate in the Plan but must pay the full cost of coverage.

In no event can a person receive coverage as both an employee and as a dependent of another Plan member. For example, you may not have coverage for yourself as an employee and be a dependent on the coverage of a spouse/registered same-sex domestic partner or a parent who has family coverage as a University of Minnesota employee.

In no event can an employee include a dependent on the Plan who is not eligible for coverage. The Plan reserves the right to request documentation to verify eligibility of your enrolled dependents.

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Definition of Eligible Dependents

The individuals listed on the chart on the following page are considered eligible dependents for the Plan. In addition to specifying criteria for coverage, the chart also includes information as to whether the dependent is considered qualified for favorable tax treatment under the Plan.

Relationship to Employee	Criteria for Coverage	Is Dependent Qualified for Tax Favored Treatment? (1)
Spouse	Must be legally married Your spouse must not be working full-time for an employer and receiving cash or credits 1) in place of medical coverage or 2) in exchange for medical coverage with a deductible of $750 or greater.	Qualified
Same-Sex Domestic Partner	Must be registered as same-sex domestic partner. Your same-sex domestic partner must not be working full-time for an employer and receiving cash or credits 1) in place of medical coverage or 2) in exchange for medical coverage with a deductible of $750 or greater.	Usually non-qualified. Refer to same-sex domestic partner information in this definition of eligibility
Unmarried Dependent Child To be considered a Dependent Child under the Plan, the child may meet any one of the criteria for Unmarried Dependent Child coverage listed in the middle column of this chart. A child can include your biological child, legally adopted child or child placed for the purposes of adoption, foster child, stepchild, or any other child state or federal law requires be treated as a dependent. A child can also include an eligible child of your registered same-sex domestic partner.	Dependent child - birth through beginning of the calendar year that child turns age 19	Qualified
	Child who is 50% dependent on employee - regardless of student status Dependent child through age 24 (up to the 25th birthday) if more than 50% dependent on you (the employee), regardless of the dependent's student status, OR	Qualified, with special rules for children who are living with a relative other than the parent
	Child who is a full-time student Full-time student from the beginning of the calendar year in which he/she turns age 24, and does not provide over half of his/her own support, and maintains legal residence with you	Qualified
	Disabled child Age 18 or above (no maximum) if physically or mentally disabled and either: lives with you and does not provide over 50% of his/her own support, or does not live with you but is at least 50% dependent on you For disabled children over age 24, see additional information in this definition.	Qualified
	Child not meeting any of above criteria Other child through age 24 not meeting any of the above criteria	Non-Qualified
	Child of registered same-sex domestic partner Child of registered same-sex domestic partner from birth through age 24	Usually non-qualified. Refer to same-sex domestic partner information in this definition of eligibility.

(1) “Tax Favored Treatment” refers to how dependent coverage is treated for tax purposes.

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Tax Favored and Non-Tax Favored Treatment of Dependent Coverage

If the right hand column above is marked “Qualified” for a given dependent category, it means you will pay pre-tax contributions for yourself and any dependents. It also means that the value of the University's contribution to the plan is not considered taxable income to you as the employee.

There are special rules for shared custody situations. Please refer to IRS Publication 501 or to the details of your divorce or separation agreement.
If you are providing over one-half of a child's support for a child who is living with a grandparent, sibling, aunt or uncle, the child is eligible for coverage under the Plan. However, the child is considered the dependent of the custodial individual under IRS rules, and is not eligible for tax favored coverage under the Plan.

If the right hand column above is marked “Non-qualified” for a given dependent category, it means that you will be taxed on the value of the University's contribution for your non-qualified dependent's coverage. This taxable value is called imputed income.

You will also pay the normal pre-tax employee contribution to cover yourself and any other family members. The value of the University's contribution for you and your tax qualified dependents is not considered taxable income to you as the employee.

It is your responsibility, as the employee, to determine whether a dependent is considered to be a qualified or non-qualified dependent for purposes of determining whether coverage is tax favored under the Plan and to enroll your dependent in the correct manner. One general guideline is that if the child is considered your dependent for tax purposes, he/she is eligible for coverage on a tax favored basis. Notice of any change in dependent tax status must be communicated to the University within 30 days of the change.

There are special rules about taxation of coverage for “Non-qualified” dependents that apply in limited circumstances:

When a part-time employee pays the full cost of coverage on a pre-tax basis, the cost of coverage for the “Non-qualified” dependent would still be considered imputed income for the employee because the coverage is otherwise being paid on a pre-tax basis.
When an early retiree or disabled participant pays the full cost of coverage on an after-tax basis, and has a “Non-qualified” dependent child, there is no additional taxable income requirement because the plan member is already paying the full cost of coverage.
When a former employee pays a portion of the cost of coverage on an after-tax basis, and has a “Non-qualified dependent child, the cost of coverage for the child in excess of the after-tax payment would be taxable to the former employee. This amount would be reported on a W-2 form.

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Eligible Dependent Children

An eligible child can include your own biological child, legally adopted child or child placed for the purposes of adoption, foster child, stepchild, and any other child state or federal law requires be treated as a dependent. Eligible child can also include the child of your registered same-sex domestic partner, although that coverage is generally not available on a tax favored status.

The date of placement for a child who is being adopted means the assumption and retention by a person of a legal obligation for total or partial support of the child in anticipation of adoption of the child. The child's placement with a person terminates upon the termination of the legal obligation of total or partial support.
To be considered a dependent child, a foster child must be dependent on you for his/her principal support and maintenance, and must be placed by the court in your custody.
To be considered a dependent child, a stepchild must be dependent on you for his/her principal support and maintenance and must not be a dependent child for tax purposes of any other individual. A stepchild means the child of your spouse by a previous marriage/partnership.

The child of your same-sex domestic partner can be considered a dependent child if your same sex domestic partner is registered with the University and the child meets all other requirements for an eligible child. This applies to both the children of your registered same-sex domestic partner from your current partnership or his/her previous marriage/partnership.

“Principal support” means more than half of the dependent child's support.

If both you and your spouse/registered same-sex domestic partner work for the University of Minnesota, then either of you, but not both, may cover your eligible dependent children/grandchildren. This also applies to two divorced or unmarried employees who share legal responsibility for their dependent children or grandchildren.

Your dependent grandchild is eligible as a child if he/she is the dependent child of your unmarried eligible child; if the grandchild is placed in your legal custody; or if the grandchild is legally adopted or placed with you for the purpose of adoption. The grandchild must be dependent upon you for more than one-half of his/her support, and you must claim the grandchild as a dependent on your tax return.

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Eligibility of Spouse/Registered Same-sex Domestic Partner

If both you and your spouse/registered same-sex domestic partner work for the University of Minnesota, then either of you has the option of adding the other as a dependent to his/her family coverage. The spouse/registered same-sex domestic partner added to the family coverage must waive employee coverage.

However, if your spouse or registered same-sex domestic partner works full-time for an employer and receives cash or credits (1) in place of medical coverage, or (2) in exchange for a medical coverage with a deductible of $750 or greater, then he/she is not considered to be an eligible dependent under the Plan.

Same-sex domestic partner registration criteria:

Engaged in a committed relationship and intend to remain together indefinitely;
Are the same-sex and for this reason are unable to marry each other under Minnesota law;
Are at least 18 years of age and have the capacity to enter into a contract;
Are jointly responsible to each other for the necessities of life; and
Are not related by blood closer than permitted under Minnesota marriage laws

You must complete a Declaration of Domestic Partnership form (pdf) to register your same-sex domestic partner. Further information and the form can be found on the Domestic Partnership page or by contacting Employee Benefits at 612-624-9090 or 1-800-756-2363.

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Taxability of Coverage for your Registered Same-sex Domestic Partner and the Child/Children of Registered Same-sex Domestic Partner

Under IRS rules, the value of the medical and dental benefits provided by the University to your registered same-sex domestic partner and the child/children of your registered same-sex domestic partner is generally considered taxable income to you as the employee. The only exception to the taxability of these benefits is if your registered same-sex domestic partner and his or her children meet the following IRS definition of a dependent. A registered same-sex domestic partner and his/her children can meet the definition of a dependent for the purposes of family coverage if the following conditions are met:

They lived with you for the entire year as a member of your household.
They were U.S. citizens or resident aliens of the U.S. or residents of Canada or Mexico for part of the calendar year in which your tax year began.
They did not file a joint tax return.
You provided over half of their support for the calendar year.
They are not a dependent child for tax purposes of any other individual.

If your registered same-sex domestic partner and children meet all of the above requirements, you will need to complete a Certification of Dependent Status form (pdf). Further information and the form can be found on the Domestic Partnership page or by contacting Employee Benefits at 612-624-9090 or 1-800-756-2363. Note: Most same-sex domestic partner expenses are not eligible to be reimbursed through the HSA, per IRS regulations.

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Definition of Full-time Student for Tax Favored Status Determination

A child between the beginning of the calendar year in which he/she turns age 19 through age 24 is eligible for UPlan medical and/or dental coverage regardless of whether the child is a full-time student. However, being a full-time student is one way that an individual qualifies for tax favored treatment under the Plan. The following definition of a student for the Plan is recorded in IRS Publication 501 and is as follows:

“A full-time student is a student who is enrolled for the number of hours or courses the school considers to be full-time attendance.

To qualify as a student, your child must be, during some part of each of any 5 calendar months of the year:

A full-time student at a school that has a regular teaching staff, course of study, and a regularly enrolled student body at the school, or

A student taking a full-time, on-farm training course given by a school described in (1) or by a state, county, or local agency.

The 5 calendar months do not have to be consecutive.

A school can be a high school, college, university, or technical, trade, or mechanical school. However, an on-the-job training course, correspondence school, or school offering courses only through the internet does not count as a school. Students who work on “co-op” jobs in private industry while part of a high school's regular course of classroom and practical training are considered full-time students.”

If a child between the beginning of the calendar year in which he/she turns age 19 through age 24 no longer retains full-time student status, he/she may still qualify for tax favored treatment under the plan if he/she is more than 50% dependent on the employee for support. If the child does not meet either of the criteria for tax favored coverage shown in the chart above, the child will still be eligible for the Plan, but coverage will not be on a tax favored basis.

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Coverage of Disabled Children of Any Age

Your dependent child of any age is eligible for coverage and tax favored status if he/she is incapable of self-sustaining employment by reason of mental retardation, mental illness, mental disorder, or physical disability, and is chiefly dependent upon you for his/ her support and maintenance (meaning you provide for more than one-half of the child's support).

A dependent child must be certified by the UPlan Medical Plan Administrator to be disabled prior to age 25, based on proof that the child meets the above requirements.

If for any reason, you drop coverage for a disabled dependent prior to age 25, then wish to cover the child again, coverage must be added prior to the child turning age 25, and his/her disabled status recertified by the Plan Administrator.
Once your disabled child has reached age 25, the child must be continuously covered under the Plan in order to maintain eligibility.

A disabled dependent child who is 25 years of age or older and unmarried at the time of your initial eligibility for coverage in the Plan, may be enrolled for coverage if:

you (the employee) enroll for coverage during your initial eligibility period, and;
the UPlan Medical Plan Administrator certifies that the dependent meets the above requirements. Proof of disability status must be provided within 31 days of your initial date of eligibility and enrollment in the Plan. The disabled dependent shall be eligible for coverage as long as he/she continues to be disabled and dependent, unless coverage otherwise terminates under the Plan.

A dependent child who is considered to be disabled by the UPlan Medical Plan Administrator will be eligible for tax favored coverage under the Plan, regardless of age. The disabled child of a registered same-sex domestic partner will not be eligible for tax favored coverage.

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Children Covered by Child Support Order

Children of the employee who are required to be covered by reason of a Qualified Medical Child Support Order are eligible, as required by federal and state law to assure that children who do not live with both of their biological parents have adequate medical coverage. This provision does not apply to children of the spouse/registered same-sex domestic partner who are not also children of the employee.

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Not Eligible

For purposes of coverage under the Plan, your parents, grandparents, in-laws, brothers, sisters, aunts, uncles, cousins, other extended family members, non-registered same sex domestic partners and their children, and unmarried opposite-sex domestic partners and common-law spouses are not eligible dependents.

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Family Status Changes

To make changes in your medical, dental, optional life coverage, or flexible spending accounts after you are first eligible or outside of the annual open enrollment period, you must have a change in family status. The coverage change must be consistent with the family status change. A request for change in your coverage due to a family status change must be made within 30 days of the date of change. Failure to apply for a change in coverage within 30 days of the family status change means that you will not be able to make a change until the next available open enrollment period.

Family status changes include:

Change in legal marital status, including marriage, divorce, or annulment
Registration of your same-sex domestic partnership or termination of same-sex domestic partnership
Death of your spouse/registered same-sex domestic partner or last eligible dependent child
Birth or adoption of your eligible dependent child
Change in last dependent child's eligibility because of age or student status
Commencement or termination of employment for you, spouse/registered same-sex domestic partner, or dependent
Change in your or your spouse/registered same-sex domestic partner's employment status from part time to full time or from full time to part time
Change in the place of residence or worksite for you, spouse/registered same-sex domestic partner, or dependent to a location outside of the current plan's service area and the current plan is not available

If you have more specific questions about changes in your coverage, call the Employee Benefits Service Center at 612-624-9090 or 800-756-2363 and select Option 2.

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