Open Enrollment – Eligibility - Human Resources at Ohio State

2018 Open Enrollment

November 1-14, 2017

Eligibility

Ohio State’s total rewards package includes benefits that support your health, finances, work-life balance and education. Ohio State uses certain criteria to define benefits eligibility and employee contribution rates for benefit coverage. Employee Self Service will offer you the benefit elections for which you are eligible.

An additional resource to determine your eligibility for certain benefits is the interactive Benefits Eligibility Tool. Select your criteria to get general information about your eligibility for specific benefits. Definitions of classification, appointment type and full-time equivalency are included.

Dependent Eligibility Verification

Review dependent eligibility requirements below for each of the dependents on your medical, dental, and/or vision plan, as well as any whom you intend to add during Open Enrollment.

  • To ensure the accuracy of Affordable Care Act (ACA) reporting to the IRS, please verify that the name, date of birth and social security number on file for each covered dependent identically matches IRS records. If you need to correct any dependent information, please contact Customer Service at (614) 292-1050 or (800) 678-6010.
  • If any currently covered dependents will no longer meet eligibility guidelines as of January 1, 2018, remove them from coverage during Open Enrollment.
  • Ohio State requires verification of eligibility for any dependent enrolled in its medical, dental and vision plans. A request for proof of eligibility for any covered dependent who has not previously been verified will be mailed to you in January 2018. Follow the steps to submit the required document by the deadline stated in the packet. Failure to provide proof of eligibility for each applicable dependent will result in termination of their coverage.

2018 Dependent Eligibility Requirements

The benefits available to you and your family reflect Ohio State’s commitment to offering high-quality, affordable options for your family’s health, financial and educational needs. Use the detailed information below to determine if your spouse, children and domestic partners are eligible for Ohio State’s medical, dental and vision benefits.

An individual whose marriage to a covered employee is recognized by the Internal Revenue Service for federal income tax purposes.

A dependent child of a covered employee who meets all of the following eligibility criteria:

  • Has not reached the age limit of 26 (e.g., 26th birthday); and
  • Fits into one of the following categories:
    • Employee’s biological child
    • Employee’s adopted child or child placed with the employee for adoption
    • Employee’s step-child
    • Child for whom the employee has legal guardianship, or legal custody, and such child is the employee’s tax dependent; or
    • The child of the employee’s, covered same-sex domestic partner provided that the child was enrolled in The Ohio State University Faculty and Staff Health Plans as a child of the employee’s covered same-sex domestic partner as of December 31, 2017.  For these purposes, “covered, same-sex domestic partner” means a same-sex domestic partner enrolled in The Ohio State University Faculty and Staff Health Plan for the 2018 plan year.

A dependent child may be eligible for continued coverage as a dependent child after attaining age 26 if these four criteria are met:

  • The child is and continues to be incapable of self-sustaining employment by reason of mental retardation, or mental or physical disability.
  • The child is and continues to be primarily dependent upon the employee for support and maintenance.
  • The child was:
    • Covered by a university medical plan when he or she reached the limiting age and the employee makes application for continuation of coverage to the university within 31 days after the child reaches the limiting age, or
    • Covered as a dependent under the medical plan of his or her parent’s employer immediately prior to a loss of coverage under such plan (documentation of prior coverage required) and the employee makes application for continuation of coverage to the university within 31 days after such loss of coverage occurs. In each case, the employee must provide satisfactory proof of the child’s incapacity and dependence upon the employee.
  • The employee provides proof of the continuance of such incapacity and dependence upon request by the university.

An Affidavit of Same-Sex Domestic Partnership is required. The same-sex domestic partner of a covered employee who meets all of the following eligibility criteria:

  1. The individual was enrolled in The Ohio State University Faculty and Staff Health Plans as a same-sex domestic partner as of December 31, 2017; and
  2. The individual meets all of the following criteria:
    1. Shares a permanent residence with the employee (unless residing in different cities, states or countries on a temporary basis);
    2. Is the sole same-sex domestic partner of the employee, has been in a relationship with the employee for at least six (6) months and intends to remain in the relationship indefinitely;
    3. Is the same sex as the employee and is not currently married to or legally separated from another person under either statutory or common law;
    4. Shares responsibility with the employee for each other’s welfare;
    5. Is at least eighteen (18) years of age and mentally competent to consent to contract;
    6. Is not related to the employee by blood to a degree of closeness that would prohibit marriage in the state in which they legally reside; and
    7. Is financially interdependent with the employee in accordance with the requirements outlined by Ohio State below. Financial interdependency may be demonstrated by the existence of three (3) of the following:
      1. Joint ownership of real estate property or joint tenancy on a residential lease
      2. Joint ownership of an automobile
      3. Joint bank or credit account
      4. Joint liabilities (e.g. credit cards or loans)
      5. A will designating the same-sex domestic partner as primary beneficiary
      6. A retirement plan or life insurance policy beneficiary designation form designating the same-sex domestic partner as primary beneficiary
      7. A durable power of attorney signed to the effect that the employee and the same-sex domestic partner have granted powers to one another.
  • A spouse, same-sex domestic partner or sponsored dependent who would otherwise be eligible for coverage, but who is on active duty in any military, naval or air force of any country is not eligible for coverage during the period of active duty.
  • Dependents who do not meet the eligibility requirements outlined in this section.

 

Open Enrollment Information