Domestic Partner Insurance Coverage Question

Factual Questions
1

So our health insurance open season at work just ended on Friday; as I will just complete my first year with this firm in mid-October, I had no idea that open enrollment is in August until nearly halfway through the month, and we didn’t have the insurance company come in to give presentations on our coverage details, etc. until August 15th, halfway through the open season. They gave us a fairly comprehensive set of booklets, etc. with details on coverage, options, etc., and told us that we could log in to their website if we needed further details regarding in-network providers, drug formulary, discounts on alternative health providers, etc.

So yesterday I finally managed to log into the insurance company website for the first time (I’d gotten errors on multiple previous attempts to register), and under the “My Coverage” section, among other things, found a Domestic Partnership Coverage rider with the following text:

"RIDER TO THE CERTIFICATE REGARDING DOMESTIC PARTNERSHIP

The Certificate, to which this Rider is attached and becomes a part, is amended
as stated below.

A. DEFINITIONS
The following definitions are added to the Definitions Section:
Domestic Partner……means a person with whom you have entered into a Domestic
Partnership.
Domestic Partnership……means a long-term committed relationship of indefinite
duration with a person which meets the following criteria:
(i) you and your Domestic Partner have lived together for at least 6 months,
(ii) neither you nor your Domestic Partner is married to anyone else or has
another domestic partner,
(iii) your Domestic Partner is at least 18 years of age and mentally competent
to consent to contract,
(iv) your Domestic Partner resides with you and intends to do so indefinitely,
(v) you and your Domestic Partner have an exclusive mutual commitment
similar to marriage, and
(vi) you and your Domestic Partner are jointly responsible for each other’s
common welfare and share financial obligations.

B. ELIGIBILITY

  1. The first and second paragraphs of the Changing From Individual To Family
    Coverage section are deleted and replaced with the following:
    You can change from Individual to Family Coverage, either because of:
    marriage
    establishment of a Domestic Partnership
    the birth or adoption of a child
    obtaining legal guardianship of a child
    previous health insurance coverage terminating which was in effect when
    you were first eligible to enroll for coverage under this Certificate and
    which is not terminating for failure to pay premiums or fraudulent cause,
    and where required, you stated in writing that coverage under another
    group health plan or other health insurance coverage was the reason for
    declining enrollment.

If you make application for this change within 31 days of the marriage, establishment
of a Domestic Partnership, birth, adoption, interim court order of adoption
or placement of adoption vesting temporary care or obtaining legal guardianship,
your Family Coverage will be effective from the date of the marriage, establishment
of a Domestic Partnership, birth, adoption, interim court order of adoption
or placement of adoption or legal guardianship.
2. The following is added as the third paragraph under Family Coverage:
Your enrolled Domestic Partner and his or her enrolled unmarried children who
have not attained the limiting age stated above will be covered. Whenever, the
term “spouse” is used, we also mean Domestic Partner. All of the provisions of
this Certificate that pertain to a spouse also apply to a Domestic Partner.
3. The first and second paragraphs of the Adding Dependents To Family Coverage
section are deleted and replaced with the following:
You can add additional dependents to your Family Coverage, either because of:
marriage
establishment of a Domestic Partnership
the birth or adoption of a child
obtaining legal guardianship of a child
previous health insurance coverage terminating which was in effect when
you were first eligible to enroll for coverage under this Certificate and
which is not terminating for failure to pay premiums or fraudulent cause,
and where required, you stated in writing that coverage under another
group health plan or other health insurance coverage was the reason for
declining enrollment.

If you make application to add additional dependents to your Family Coverage
within 31 days of the marriage, establishment of a Domestic Partnership, birth,
adoption, interim court order of adoption or placement of adoption vesting temporary care or legal guardianship, coverage for your dependents will be effective from the date of the marriage, establishment of a Domestic Partnership, birth, adoption, interim court order of adoption or placement of adoption or legal guardianship.
However, an application to add a newborn to Family Coverage is not
necessary if an additional premium is not required. Please notify your Group Administrator so that your membership records can be adjusted.

Except as amended by this Rider, all terms, conditions, limitations and exclusions
of the Certificate to which this Rider is attached will remain in full force and effect."

Now my boyfriend, who meets all the domestic partner criteria lsited above, is currently job-hunting and has no health insurance, but would very much like to.
I just talked to our office manager, who has a call in to the insurance broker to ask whether it’s even possible to add a domestic partner outside of open enrollment (which ended on Friday), and if so, what the cost would be, but if the coverage even exists in our plan (as opposed to just being some sort of template included there by mistake, which I doubt because they have other specific info on that page related to me and my coverage), needless to say I am disgusted that this is mentioned NOWHERE in any of the other written materials I have ever been provided.

The only things I can think of to say if they tell me that I can’t add him because open enrollment has ended are a) how the hell am I supposed to add him if they gave me no indication in any of their written materials that the coverage even exists? and b) I am trying to think of a way I could argue that the domestic partnership, as defined above, was established in the past 31 days. (The Reader’s Digest version: he moved in with me last Labor Day weekend, and has had a hell of a time finding a permanent job - he had a long-term temp job that was supposed to last 5 months, but they laid him off after 2 months for lack of work. So I’ve been covering most of the expenses - I figure I’d be paying rent, utilities, etc. if I were living alone anyway, and what goes around comes around. But our first actual legally contracted joint financial obligation would be the lease on our current apartment, which started in May - he was laid off literally the week after we moved in.)

So any other ideas? Can I really be expected to enroll for benefits that I didn’t know existed? I am beyond aggravated at this point. Hopefully he will get the job he just interviewed for, and the whole thing will be moot, but right now I am really pissed off.

2

The term you need to find is “Qualified Event” or something along those lines. I’ve also seen the term “Qualifying Life Event.”

My company allows enrollment changes within 60 days after a QE such as getting married or divorced, having a baby, and entering into or dissolving a registered domestic partnership. So, if you two file for domestic partnership now (I have no idea what the process is in your state) you’ll then have a QE and will then be able to add him to your coverage.

If you two have been domestic partners for over 31 days as of now, then you’d not be able to add him until the next open enrollment.

3

There is no domestic partnership registry in Illinois or Cook County for opposite-sex domestic partners (only same-sex).

I’m trying to figure out whether there is some other way to define the qualifying event of “entering into a domestic partnership” that would work, given the constraints of the rider. I mean I’m not trying to lie or pull the wool over anyone’s eyes, but it was basically impossible for me to know about this until it was too late to do anything about it, unless they are flexible about defining the moment of entering into a domestic partnership. I seriously would have had to be psychic.

4

Unfortunately, it sounds like you’re out of luck unless you two get married or Illinois starts registering mixed-sex domestic partnerships soon.

However… It sounds as if the insurance company isn’t demanding DPs to be registered with the state. They may be satisfied with your saying that the two of you are DPs and showing evidence of shared financial responsibilities such as both of your names on a bank account or lease. Whether or not you can convince them that you’ve done this within the past 31 days may be the hardest part.

5

Update: the office manager just gave me a bunch of forms frm the insurance company, which I am supposed to return by Friday if we want the additional insurance coverage. One of them is a domestic partner affidavit, which I erally have no problem with. The other is an information sheet regarding the tax consequences of domestic partner health benefits. (I am pissed that somehow between now and Friday, I am supposed to find and meet with a tax consultant about this stuff? This is complicated, and I’ve never had to deal with it before.)

As far as I understand fromt his sheet, my employer’s contribution toward insurance coverage for my partner is considered to be taxable income, unless he is cosidered to be my dependent for Federal tax purposes. In order to be my dependent for Federal tax purposes, I am supposed to be contributing more than half of his support. (I suppose I am at the moment, but we are both hoping that will change in the very near future, of course.)

I have no particular desire to have him as a dependent for tax purposes (and I don’t think he wants to be, either), but how can we predict the future? Should I just assume he isn’t my dependent, and as he intends to pay for his portion of the health care expenses, we can come up with some mutually agreeable way to do that, considering that a portion of the insurance expense is going to be deemed to be my income? Is there anything else I should know about this?