Welcome to the Benefit Eligibility section of My Life at Children’s. Here, you will find information about when you can enroll and who you can cover under your healthcare plan options.

Benefit Eligibility

When You Can Enroll

Current Employees

The benefit choices you make during Annual Enrollment will be effective Jan. 1 through Dec. 31 each year unless you experience a qualifying life event. You will receive more information on Annual Enrollment in the fall. See Making Benefit Changes for more details.

New Employees

If you are a new employee at Children’s and you enroll through Lawson Employee Self-Service within 30 days of your date of hire (your initial enrollment period), your benefit coverage will take effect the first day of the month following your date of hire. If you do not enroll within 30 days of hire, you will not be able to enroll until Annual Enrollment, unless you experience a qualifying life event.

Who Is Eligible

You are eligible for most of the benefit plans if you are a regular full-time employee of Children’s or a regular part-time employee who is committed to working at least 40 hours per pay period. You can also enroll your eligible dependents in most of the benefit plans (see domestic partner restrictions below).

Eligible dependents include:

• Your legal spouse.
• Your married or unmarried child(ren)* up to age 26.
• Your unmarried child(ren)* of any age, if mentally or physically incapable of self-support.
• Your same-sex domestic partner** and/or your domestic partner’s children.*
• Children for whom you must provide health plan coverage under the terms of a Qualified Medical Child Support Order (QMCSO). Children’s is responsible for determining if an order meets the QMCSO criteria. You may request a free copy of these procedures by contacting Human Resources Benefits.

A dependent cannot also be enrolled as a participant. No one can be a dependent of more than one participant.

*Your children include natural children, step-children, your domestic partner’s children who live with you and who qualify as dependents on your domestic partner’s federal income tax return, legally adopted children, children placed for adoption, and children for whom legal guardianship has been awarded to you or your spouse. You must reimburse Children’s for any benefits paid for a child at a time when the child did not satisfy these conditions.

**Your domestic partner (as defined by Children’s below).

Domestic partner means someone of the same sex who has a long-term committed relationship with you of indefinite duration. Both you and your domestic partner must meet all of the criteria below:

• Be at least age 18 and mentally competent to enter into a contract in the state in which both of you reside.
• Not legally married to another person of the opposite sex or in a domestic partnership with another person.
• Not related by blood to a degree of closeness that would prohibit marriage.
• In an exclusive, committed relationship that is intended to be permanent.
• Share a mutual obligation of support and responsibility for each other’s welfare.
• Share a principal residence and intend to do so permanently.
• Be financially interdependent by sharing common assets and common debts, as verified by providing Human Resources Benefits with two current documents from the list below:
  • Joint lease, mortgage or deed.
  • Valid driver’s license or state-issued, non-driver ID for each of you showing the same home address.
  • Utility bill, rent bill or rent receipt verifying a shared residence.
  • Proof of joint checking, savings, credit card or brokerage account.
  • Proof of joint ownership of a vehicle.
  • Designation of your domestic partner as your beneficiary for your Employee Life Insurance or retirement account.

Note: You may not cover a same-sex domestic partner or their children under the Humana DHMO dental plan option or Spouse Life Insurance.

Working Spouse/Domestic Partner Surcharge

If your spouse or domestic partner’s employer offers medical coverage and you elect coverage for your spouse or domestic partner under a Children’s medical plan option, you will pay a working spouse/domestic partner surcharge of $50 per month (pre-tax) for your spouse or domestic partner’s coverage. This surcharge does not apply if your covered spouse or domestic partner does not work, does not have subsidized group medical coverage available through an employer, or is employed by Children's Medical Center.

Automatic Benefits

As a benefits eligible employee, you will be automatically enrolled in the following coverage at no cost to you:

• Basic Employee Life.
• Basic Accidental Death & Dismemberment (AD&D).
• Short Term Disability.
• Long Term Disability.

Optional Benefits

As a benefits eligible employee, you have the option to enroll in the following:

• Medical.
• Dental.
• Vision.
• Supplemental Employee Life.
• Supplemental Accidental Death & Dismemberment (AD&D).
• Spouse Life Insurance.
• Child Life Insurance.
• Healthcare Flexible Spending Account (FSA).
• Dependent Care (Day Care) Flexible Spending Account (FSA).

Additional benefits and services available to you can be found under Savings, Time Away and Other Benefits. These benefits/services may have different eligibility. See individual programs/benefits to know who is eligible.