FAQs. General Questions on Domestic Partnership. 1. What is a domestic partnership?

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1 FAQs General Questions on Domestic Partnership 1. What is a domestic partnership? As defined by the CHEIBA Trust, a domestic partnership is one that meets the criteria outlined in the "Affidavit of Domestic Partnership." In brief, it is a relationship of two individuals who have an exclusive mutual commitment, similar to marriage, in which the partners agree to be jointly responsible for each other s common welfare, living expenses, and financial obligations. The individuals must be each other s sole domestic partner and intend to remain so indefinitely. Both partners must be at least 18 years of age, not be related by blood to a degree of closeness that would prohibit marriage in their state of residence, and not be legally married. The individuals must currently be residing together and have resided together in a shared principal residence for at least twelve consecutive months and intend to reside together indefinitely. 2. For which benefits is my domestic partner eligible? If you are a benefits eligible faculty or staff member, your domestic partner is eligible for coverage under the medical, dental, voluntary life, voluntary accidental death and dismemberment (AD&D), and voluntary vision insurance plans. A domestic partner is subject to the same plan or program provisions and requirements as a spouse. All of the benefits are subject to the plan provisions. 3. For which benefits are the children of my domestic partner eligible? If you are a benefits eligible faculty or staff member, your domestic partner s children are eligible for coverage under the medical, dental, voluntary life, voluntary AD&D, and voluntary vision insurance plans the same as any other dependent child. Children of a domestic partner must meet the requirements established by the CHEIBA Trust to be considered a dependent. In accordance with the Trust Agreement, as amended, the married or unmarried child or children are eligible until the end of the month of their 26 th birthday. The term child or children are defined to include the natural or biological child, step-child, legally adopted child, child legally placed for adoption, child under legal guardianship, child or children of any age who are medically certified by a physician as disabled, and a child for whom the Employee or domestic partner is required to provide health benefits pursuant to a court order or qualified medical child support order, provided however, the term child or children shall not include the grandchild or grandchildren of the Employee or the domestic partner. All of the benefits are subject to the plan provisions. 4. How do I register my domestic partnership to obtain benefits? To register, you and your domestic partner must complete, sign, and return to Human Resources, an "Affidavit of Domestic Partnership" and all supporting documentation. These forms are available from your Human Resources Office. Page 1 of 3

2 5. Do I need to provide proof of my partnership? You must provide evidence that you and your domestic partner maintain a shared principal residence as documented by one (1) of the following: a. driver s license or state Identification card for both partners showing the same principal residence, b. lease of principal residence bearing the name of both partners; c. deed to principal residence bearing the name of both partners; or d. mortgage of principal residence bearing the name of both partners. A copy of the document shall be attached to the Affidavit. In addition, you must provide evidence that you and your domestic partner are jointly responsible for each other s common welfare as documented through one (1) of the following: a. joint credit card, b. joint bank account, c. designation of Domestic Partner as beneficiary for a life insurance or retirement contract, d. designation of Domestic Partner as primary beneficiary in the Employee s will, e. joint designation of durable powers of attorney authorizing each of them to act on behalf of the other, or f. jointly named on auto, renters or homeowners insurance policies. A copy of the document shall also be attached to the Affidavit. 6. When can I enroll my domestic partner? You can enroll a domestic partner: within thirty-one (31) days of being hired into a benefits eligible appointed position, or during a CHEIBA Trust member school s annual Open Enrollment period for benefits effective the following January 1st, or within thirty-one (31) days of all IRS-defined change of status (e.g., birth/adoption of a child or loss of a partner's coverage through his or her employer), or within thirty-one (31) days of meeting the criteria to establish a domestic partnership as defined by CHEIBA Trust. 7. When is the coverage effective? The same coverage effective dates apply for domestic partnerships as for spouse and dependent coverage. In general, the coverage is effective with the first date of eligible employment if an Affidavit of Domestic Partnership and all supporting documentation are submitted within the first thirty-one (31) days of employment; is effective on January 1 of the plan year immediately following open enrollment; or is effective with a change in status as defined within a Benefit Plan. All of these possible effective dates require the employee to timely file an Affidavit of Domestic Partnership and all supporting documentation. If a filing deadline is not met, the domestic partner is not eligible for coverage until the next available period for enrollment, usually the next open enrollment period. Page 2 of 3

3 8. Are there tax implications to me of covering my domestic partner or dependents of my domestic partner? If you add a domestic partner to your insurance, you will likely create additional federal and state tax obligations for yourself. An exception to this general rule is if your domestic partner and dependents of the domestic partner, if any, can qualify as tax dependents under sections 152 and 105(b) of the Internal Revenue Code. Please see the handout Important Tax Information for domestic partner Health and Dental Benefits for more information on this complex question. 9. If my domestic partner and I end our relationship, do I have to continue to carry my domestic partner or dependents on my insurance plans? While unfortunate, relationships end from time to time. If you end a domestic partnership, you are required to file a Statement of Termination of Domestic Partnership document with your Human Resources Office within thirty-one (31) days of the termination of the domestic partnership. Additionally, you are required to mail a copy of the Statement to your domestic partner within ten (10) days of its filing. Unless COBRA coverage is elected, benefits will cease for your domestic partner and his or her dependents on the first day of the month following the date of the termination of the domestic partnership. 10. What if my domestic partnership is ended, but I fail to file the Statement of Termination of the Domestic Partnership? It is very important that you timely file a Statement of Termination of Domestic Partnership so that you do not become liable for benefits that may be paid for services that were obtained after the coverage should have ended had timely notification been filed by you. 11. If I end my domestic partnership, is there a waiting period before I can register another domestic partner for benefits? Yes. Once a domestic partnership is terminated, you cannot register another domestic partnership for at least twelve (12) months. 12. Once I enroll my domestic partner for medical and dental benefits, may I use my medical flexible spending account for reimbursement of the medical and dental expenses of my domestic partner? Generally, no. Unless your domestic partner is certified as an IRS-defined tax qualified dependent of yours, you cannot submit his or her expenses for reimbursement under the flexible spending plan. Please consult the Important Tax Information for domestic partner Medical and Dental Benefits and Certification of Tax Qualified Dependents forms available through your Human Resources office for more information about what is required to establish a tax qualified domestic partner. 13. Are there other legal concerns of which I should be aware if I choose to register my domestic partner for benefits? Possibly, yes. The Affidavit of Domestic Partnership required to register a Domestic Partner includes an attestation of the relationship. Due to the legal obligations that may be created between the employee and the Domestic Partner by submitting such an affidavit, both parties are advised to consult an attorney for advice. Note: If there are any discrepancies between the information contained in these FAQs and the Trust Agreement or the benefit plan documents, the terms of the Trust Agreement or the benefit plan documents, as applicable, will control. Page 3 of 3

4 Important Tax Information for Domestic Partner Medical and Dental Benefits The General Rule The amount of your contribution to provide medical and dental benefits for a domestic partner and children of a domestic partner will be the same as for a spouse and his or her children. However, the Internal Revenue Code treats spouses and children through marriage differently with respect to medical and dental benefits. The cost of coverage for a spouse, children or stepchildren is automatically exempt from taxes, but for a person who is not a spouse, child or stepchild through marriage, the value of employer-provided medical and dental benefit coverage is not exempt from tax unless the person is a dependent as defined in Internal Revenue Code sections 152 and 105(b). How Does It Work? If your domestic partner and his or her children are your tax qualified dependents for medical and dental care coverage under sections 152 and 105(b) of the Internal Revenue Code, you must provide your employer with a Certification of Tax Qualified Dependents to that effect to gain the benefit of the tax exemption. If your domestic partner and his or her children qualify as tax qualified dependents, the cost of coverage (that you pay, if any) under your employer s benefit programs can be deducted from your pay on a pre-tax basis and no additional amount will be considered additional income to you. The Certification of Tax Qualified Dependents may be obtained from the Human Resources Office. If your domestic partner and his or her children are not your tax qualified dependents, payments you make, if any, for medical and dental coverage usually will be deducted from your salary on a pre-tax basis (see note below). Then, the total value of the coverage provided to your domestic partner and his or her children under the medical and dental plans will be considered taxable income to you. This value is treated as monies that are imputed (included) for taxing purposes only; therefore, no additional monies are received in your paycheck. State and federal income taxes and FICA taxes on imputed income will be withheld each pay period by your employer. Income tax withholding rates will be in accordance with your W-4. The value of domestic partner coverage under the medical and dental plans will be included as income in your W-2, which Metropolitan State University of Denver issues after the tax year ends. Note: If you pay for premiums on a post-tax basis, the total value of the coverage provided to your domestic partner and his or her children under the medical and dental plans, LESS your premium payment for that coverage, will be considered taxable income to you. This amount will then be treated as imputed income and taxed as described above. How is the "value" of domestic partner coverage determined? Rev

5 The value of your domestic partner coverage under the medical and dental plans is generally the difference between the total cost of coverage for yourself only and the total cost of coverage for yourself, your domestic partner and his or her children (if any). When is my domestic partner considered my dependent for medical and dental coverage purposes? In general, under the definitions in Sections 152 and 105(b) of the Internal Revenue Code, your domestic partner is a dependent for medical and dental plan purposes if: 1. Your domestic partner is a member of your household and has his or her principal residence in your home. 2. You furnish over half of your domestic partner s support for the year. In making this calculation, the amount you contribute towards your domestic partner s support must be compared with the amounts received for support of your domestic partner from all other sources, including any amounts supplied by him, or her and including earnings. 3. Your domestic partner is a U.S. citizen or national or a resident of the U.S., Canada or Mexico. 4. Your relationship with your domestic partner does not violate local law. (Caution: The above rules apply to tax dependency for medical and dental plan purposes only. Additional rules may apply before you may claim an individual as your dependent for other tax purposes.) If you elect to have the eligible children of your domestic partner covered by the medical and dental plans, the same rules on dependency apply. The value of coverage will be taxable to you unless the children are your dependent(s) as described above. So, if the children do not maintain their principal residence in your home but still receive over half of their support from you, the children are not your tax qualified dependents and the value of coverage under the medical and dental plans will be taxable to you since the children do not maintain a principal place of residence in your home. If your domestic partner and his or her children experience a change in status that converts your domestic partner or his or her children to a tax qualified dependent, you should complete a Certification of Tax Qualified Dependents within thirty-one (31) days of the modification and return it to your employer so that the value of coverage of benefits provided under the medical and dental plans will not be taxed. Employees considering domestic partner coverage are advised to seek professional tax advice on this matter. CHEIBA Trust and MSU Denver do not intend this information to be legal tax advice, and do not warrant the accuracy of the information provided on this matter. CHEIBA Trust and MSU Denver will not accept responsibility for any loss or tax liability of the employee or his or her partner in the offering of domestic partner benefits. Rev

6 THE CHEIBA TRUST DOMESTIC PARTNERSHIP BENEFITS SUMMARY Effective January 1, 2009, the Colorado Higher Education Insurance Benefits Alliance Trust (the "CHEIBA Trust") modified the definition of Dependent to include Domestic Partners of covered employees. This means that Domestic Partners are eligible for group medical, dental, voluntary vision, voluntary life, and voluntary accidental death and dismemberment benefits offered by member schools. A Domestic Partner is an adult who shares a committed relationship and a shared principal residence with a member school s eligible employee of the same or opposite gender, evidenced by an Affidavit of Domestic Partnership filed by the employee with their respective employer. Affidavit of Domestic Partnership: The Affidavit of Domestic Partnership shall contain an affirmation by the Employee and the Domestic Partner of the following: They are both at least eighteen (18) years of age and are mentally competent to contract. Neither is legally married to another person, nor is either a member of another domestic partnership. They are sole Domestic Partners and have been living together as Domestic Partners in a shared principal residence for at least twelve (12) consecutive months preceding the date of the Affidavit, and they intend to remain sole Domestic Partners indefinitely. They are not related by blood closer than permitted by state law for marriage in the State of Colorado. They maintain a shared principal residence as documented by one (1) of the following: a. driver s license or state Identification card for both partners showing the same principal residence, b. lease of principal residence bearing the name of both partners; c. deed to principal residence bearing the name of both partners; or d. mortgage of principal residence bearing the name of both partners. A copy of the document shall be attached to the Affidavit. They are jointly responsible for each other s common welfare as evidenced through one (1) of the following: joint credit card, joint bank account, designation of Domestic Partner as beneficiary for a life insurance or retirement contract, designation of Domestic Partner as primary beneficiary in the Employee s will, joint designation of durable powers of attorney authorizing each of them to act on behalf of the other, or jointly named on auto, renters or homeowners insurance policies. A copy of the document shall also be attached to the Affidavit. They understand and agree that if insurance benefits are fraudulently obtained or provided as a result of their declarations contained in the Affidavit, they will be jointly liable for any benefits received through insurance procured under the Affidavit, including attorneys fees that may apply. In addition, the Employee may be subject to disciplinary action, up to and including termination of employment. It has been at least twelve (12) months since a previous Statement of Termination of Domestic Partnership from either individual has been filed (if applicable). They understand that a Domestic Partner enrolled as a dependent ceases to be an eligible member on the first day of the month following the termination of such domestic Rev

7 partnership and that the Employee agrees to submit a Statement of Termination of Domestic Partnership form and an Enrollment Application/Change Form within thirty-one (31) days of the termination of the domestic partnership. The Affidavit of Domestic Partnership must be signed by both partners and witnessed by a notary public. Legal Concerns The Affidavit of Domestic Partnership required to register a Domestic Partner includes an attestation of the relationship. Due to the legal obligations that may be created between the employee and the Domestic Partner by submitting such an affidavit, both parties are advised to consult an attorney for advice. Eligibility for Coverage Domestic Partners and their eligible dependents will be eligible for medical, dental, voluntary vision, voluntary life, and voluntary accidental death and dismemberment insurance in the same manner as for an employee's spouse and other dependent children. In order to be eligible for coverage, "eligible dependent children" of Domestic Partners must: be under 26 years of age, married or unmarried, be a natural or biological child, step-child, legally adopted child, child legally placed for adoption, child under legal guardianship, child or children of any age who are medically certified by a physician as disabled, and a child for whom the Employee or domestic partner is required to provide health benefits pursuant to a court order or qualified medical child support order, provided however, the term child or children shall not include the grandchild or grandchildren of the Employee or the domestic partner. otherwise meet the definition of eligible dependent children under the CHEIBA Trust and its group medical, dental, vision, life, and accidental death and dismemberment plans. Enrollment Procedure Enrolling a Domestic Partner is subject to the same limitations that apply to a spouse or child. Enrollment is limited to: within thirty-one (31) days of being hired into a benefits eligible appointed position, or during an annual Open Enrollment period for benefits effective the following January 1st, or within thirty-one (31) days of all IRS-defined change of status (e.g., birth/adoption of a child or loss of a partner's coverage through his or her employer), or Within thirty-one (31) days of meeting the criteria to establish a domestic partnership as defined by the CHEIBA Trust. To enroll, the Employee must file an Affidavit of Domestic Partnership and attach all supporting documentation to enroll a Domestic Partner and the Domestic Partner's children. Termination of Domestic Partnership In the event a domestic partnership ends, the Employee is required to file a Statement of Termination of Domestic Partnership form within thirty-one (31) days of the termination of the domestic partnership. If there is any change in status of the criteria set forth in the Affidavit of Domestic Partnership that would terminate the domestic partnership, the employee must Rev

8 similarly complete a Statement of Termination of Domestic Partnership and return it to the Office of Human Resources within thirty-one (31) days of the change. Medical, dental, life, vision and accidental death and dismemberment benefits for the Domestic Partner and their eligible children, if any, will be discontinued on the first day of the month following the date of the termination of the domestic partnership. However, the Domestic Partner will be eligible for medical, dental, and vision coverage should the Domestic Partner enroll in COBRA coverage. The respective employer will provide any applicable notice of rights to continue benefit coverage to the former Domestic Partner. The employee must also mail a copy of the Statement of Termination of Domestic Partnership to the former Domestic Partner within ten (10) days of completing the Statement. Once a Statement of Termination of Domestic Partnership has been submitted, the employee may not establish another domestic partnership until twelve (12) months after the termination of the previous domestic partnership. Employee Liability If the employee fails to file a Statement of Termination of Domestic Partnership on a timely basis, or otherwise supplies any false or misleading statements in order to obtain Domestic Partner benefits to which the employee is not otherwise entitled, the employee shall be liable to the CHEIBA Trust or his or her employer for all resulting monetary damages, costs and attorneys' fees which result from such actions. In addition, the Employee may be subject to disciplinary action, up to and including termination of employment. Flex Plans If the Domestic Partner and his/her children are the employee's tax dependents for medical and dental plan purposes and the employee has completed a Certification of Tax-Qualified Dependents, then the employee may receive reimbursements of their expenses from the employee's flexible spending account. If the Domestic Partner and his/her children are not the employee's tax dependents, however, then their expenses are not eligible for reimbursement from the employee's flexible spending account. Benefits relating to the Domestic Partner and his/her children under dependent care assistance flexible spending accounts will depend on how the Domestic Partner and/or his or her children fit within the guidelines established by the federal tax code for these benefits. COBRA While continuation of medical, dental and vision care coverage is not required under federal COBRA laws, such coverage is allowed under the same terms that would apply to an employee's spouse and children. A registered Domestic Partner and/or children of the domestic partner enrolled in medical, dental and vision plans have sixty (60) days from the date that eligibility for coverage ends to enroll in COBRA coverage. Tax Effect IRS regulations require the employer to tax the employee for the excess of the fair market value of coverage provided to the Domestic Partner and his/her children over the amount the employee pays, if any, for the coverage. In general, an employee s premiums for coverage of a Rev

9 Domestic Partner or dependent of a Domestic Partner are paid on an after-tax basis. There is an exception to this rule if the Domestic Partner and his/her children are tax dependents for medical and dental plan purposes. Please review the document entitled "Important Tax Information for Domestic Partner Health and Dental Benefits," and complete the Certification of Tax-Qualified Dependents, if appropriate. Benefit Availability Although the CHIEBA Trust and the member schools intend to offer domestic partnership benefits for medical, dental, voluntary vision, voluntary life, and voluntary accidental death and dismemberment insurance indefinitely, such benefits are dependent, in part, on their availability in the group health insurance market. As always, the CHIEBA Trust and its member schools reserve the right to amend, suspend or terminate its benefit plans at any time in accordance with the Trust Agreement, as amended. Rev

10 Affidavit of Domestic Partnership Note: The definition of Domestic Partner for purposes of this Affidavit shall be two individuals, irrespective of gender, who live together in a shared principal residence and have a long-term relationship of indefinite duration with an exclusive mutual commitment in which the Domestic Partners agree to be jointly responsible for each other s common welfare and to share financial obligations. We, the Employee and the Domestic Partner (as hereinafter identified), certify and attest under penalty of perjury that the following is true and correct: We are both at least eighteen (18) years of age, and we are mentally competent to contract. Neither of us is legally married to another person, nor is either of us a member of another domestic partnership. We are sole Domestic Partners and we have been living together as Domestic Partners in a shared principal residence for at least twelve (12) consecutive months preceding the date of this Affidavit. We have been sole Domestic Partners living together continuously since (month/day/year), and we intend to remain sole Domestic Partners indefinitely. We maintain a shared principal residence as documented by one (1) of the following: a. Driver s License or state ID for both partners, showing the same principal residence, b. Lease of principal residence bearing the name of both partners, c. Deed to principal residence bearing the name of both partners, or d. Mortgage of principal residence bearing the name of both partners. We have attached a copy of the document to this affidavit. We are not related by blood closer than permitted by state law for marriage in the State of Colorado. We are jointly responsible for each other s common welfare as evidenced by one (1) of the following: joint credit card, joint bank account, designation of Domestic Partner as beneficiary for a life insurance or retirement contract, designation of Domestic Partner as primary beneficiary in the Employee s will, joint designation of durable powers of attorney authorizing each of us to act on behalf of the other, or jointly named on auto, renters or homeowners insurance policies, and we have attached a copy of the document to this Affidavit. We understand and agree that if insurance benefits are fraudulently obtained or provided to us as a result of our declarations contained in this Affidavit, we will be jointly liable for any benefits received through insurance procured under this Affidavit, including attorneys fees that may apply. In addition, the Employee may be subject to disciplinary action, up to and including termination of employment. It has been at least twelve (12) months since a previous Statement of Termination of Domestic Partnership from either of us has been filed (if applicable). Rev Page 1 of 2

11 We understand that a Domestic Partner enrolled as a dependent ceases to be an eligible member on the first day of the month following the termination of such domestic partnership and that the Employee agrees to submit a Statement of Termination of Domestic Partnership form and an Enrollment Application/Change Form within thirty-one (31) days of the termination of the domestic partnership. IN WITNESS WHEREOF, I have executed this Affidavit on this day of, 20. Employee Name Employee Signature The foregoing Affidavit was subscribed and sworn to before me in the County of, State of Colorado, this day of, 20. [SEAL] Notary Public My Commission expires: IN WITNESS WHEREOF, I have executed this Affidavit on this day of, 20. Domestic Partner Name Domestic Partner Signature The foregoing Affidavit was subscribed and sworn to before me in the County of, State of Colorado, this day of, 20. [SEAL] Notary Public My Commission expires: Rev Page 2 of 2