University of Minnesota
Office of Human Resources
http://www.umn.edu/ohr
612-625-2016

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 eligible 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. There is no University contribution at this level of employment.

A person cannot receive coverage as both an employee and as a dependent of another UPlan 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.

Dependent Eligibility Verification

An employee cannot include a dependent on the Plan who is not eligible for coverage. The University of Minnesota has a responsibility to make sure that Plan's resources are well managed and a duty to apply the dependent eligibility rules fairly and equally. For both these reasons, the University needs to make sure that only eligible dependents are covered under the Plan.

Employees must provide documentation to verify that their dependents are eligible. For that purpose, Employee Benefits will send the following documents to newly eligible employees who add dependents to their coverage to verify their eligibility.

  • The Matrix (pdf) shows what documents are acceptable to confirm your dependent's eligibility.
  • Review the Checklist (pdf) for the steps to follow to submit your documentation to Employee Benefits.
  • See Frequently Asked Questions (pdf) for more information about the verification program.

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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 EmployeeCriteria for CoverageIs 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
Dependent ChildDependent child - birth through age 25 (up to the 26th birthday)

 

An eligible child can include your unmarried or married biological child, legally adopted child or child placed for purposes of adoption, foster child, stepchild, or any other child state or federal law requires be treated as a dependent.

Note: The spouse of your eligible married dependent child is not eligible for coverage.

See Eligible Dependent Children below for a detailed definition of eligible dependent children.

Qualified

Dependent child of registered same-sex domestic partner - birth through age 25 (up to the 26th birthday)

An eligible child can include your unmarried or married biological child, legally adopted child or child placed for purposes of adoption, foster child, stepchild, or any other child state or federal law requires be treated as a dependent.

Note: The spouse of your eligible married dependent child is not eligible for coverage.

See Eligible Dependent Children below for a detailed definition of eligible dependent children.

Usually non-qualified.

Disabled child - age 26 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 25, see Coverage of Disabled Children of Any Age below.

Qualified
Dependent Grandchild

A grandchild is eligible for coverage if he/she is your tax dependent; 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.

Qualified

Your unmarried grandchild is also eligible for coverage if (1) he/she is in your legal custody and dependent upon you for principal support and maintenance, but is a qualified tax dependent of another person or (2) your unmarried grandchild is the dependent child of your unmarried dependent child, and even though the grandchild may be dependent upon you for principal support and maintenance, he/she would not be eligible to be your tax dependent under tax regulations. In these instances, the contributions made by the University to your grandchild’s coverage as well as your contributions are considered taxable income on your tax returns.

Usually non-qualified

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


Eligible Dependent Children

An eligible child, unmarried or married, 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.

  • For a child who is being adopted, the date of placement means the date you assume and retain the legal obligation for total or partial support of the child in anticipation of adoption of the child. A child's adoption placement terminates upon the termination of the legal obligation of total or partial support.
  • To be considered a dependent child, a foster child must be placed by the court in your custody.
  • To be considered a dependent child, a stepchild must be the child of your spouse/same-sex domestic partner by a previous marriage/partnership.

Note: The spouse of your eligible married dependent child is not eligible for coverage.

Child of your registered same-sex domestic partner

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 of Minnesota and the child satisfies 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.

Your unmarried grandchild

Your unmarried grandchild is eligible for coverage if he/she is your tax dependent; 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. In these instances, the contributions made by the University and your pre-tax contributions are not considered taxable income on your tax returns.

Your unmarried grandchild is also eligible for coverage if (1) he/she is in your legal custody and dependent upon you for principal support and maintenance, but is a qualified tax dependent of another person or (2) your unmarried grandchild is the dependent child of your unmarried dependent child, and even though the grandchild may be dependent upon you for principal support and maintenance, he/she would not be eligible to be your tax dependent under tax regulations. In these instances, the contributions made by the University to your grandchild’s coverage as well as your contributions are considered taxable income on your tax returns.

Both you and your spouse/same-sex domestic partner work for the University

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.

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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:

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

You must complete a Declaration of Same-Sex Domestic Partnership form (pdf) to register your same-sex domestic partner. Further information and the form can be found on the Same-sex Domestic Partnership page or call 612-624-UOHR (612-624-8647) or 800-756-2363 to reach the Employee Benefits Service Center.

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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:

  1. They lived with you for the entire year as a member of your household.
  2. 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.
  3. They did not file a joint tax return.
  4. You provided over half of their support for the calendar year.
  5. 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 call 612-624-UOHR (612-624-8647) or 800-756-2363 to reach the Employee Benefits Service Center. Note: Most same-sex domestic partner expenses are not eligible to be reimbursed through the HSA, per IRS regulations.

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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 26, based on proof that the child meets the above requirements.

  • If for any reason, you drop coverage for a disabled dependent prior to age 26, then wish to cover the child again, coverage must be added prior to the child turning age 26, and his/her disabled status recertified by the Plan Administrator.
  • Once your disabled child has reached age 26, the child must be continuously covered under the Plan in order to maintain eligibility.

A disabled dependent child who is 26 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
  • 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 612-624-UOHR (612-624-8647) or 800-756-2363 to reach the Employee Benefits Service Center.

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