Spouses/Domestic Partners Eligibility Criteria Covered on Medical Plans

Summary

Effective July 1, 2013, a spouse/domestic partner must elect medical coverage under their own employer's plan, if available, to be eligible for coverage under the Fred Hutchinson Cancer Center's medical plans. All employees who cover a spouse/domestic partner must complete an Affidavit of Spouse/Domestic Partner Medical Plan Coverage Eligibility.

Background

Health care coverage is a major expense for Fred Hutchinson Cancer Center. Because these costs continue to increase faster than our sources of income, we must constantly look for responsible ways to manage them.

Most employers provide health care coverage to employees as part of their total compensation package. When an employee elects this coverage, their employer's plan is primarily responsible for covering their medical expenses, even if they are also covered by another plan. The decision to require spouses/domestic partners to take their employer's coverage, when available, ensures the health care cost burden is more equitably distributed among employers.

Employees must notify Human Resources within 30 days if a spouse/domestic partner no longer meets the eligibility criteria. Inaccurate statements upon enrollment or failure to notify Human Resources of eligibility changes could result in termination of employment.

FAQ

When a person is covered by more than one plan, the claim is processed according to the Coordination of Benefit (COB) rules. Your spouse's/domestic partner's employer plan will pay first and the remainder is submitted to our plan for consideration.

Because COB rules are relatively complex and change from time to time, you will need to work with customer service at Premera (800.722.1471) or Kaiser Permanente WA (888.901.4636) to discuss what the plan may pay in your situation.

You will want to evaluate the additional premium paid vs. the additional amounts that may be covered by our plan, and whether the providers your spouse/domestic partner normally sees are considered in or out-of-network in their employer's plan.

Additionally, if a High Deductible Health Plan is offered to your spouse/domestic partner, please note that current tax regulations do not permit any contributions to a Health Savings Account if they are also covered by our plan, which is not classified as a High Deductible Health Plan (this restriction does not apply to Flexible Spending Accounts).

Contact Information

Spouses/Domestic Partners Eligibility Criteria Covered on Medical Plans

Summary

Background

FAQ

If my spouse/domestic partner has medical coverage available at their employer, but does not elect that coverage, can they be covered by our plan?

Does this change affect eligibility for the dental plan?

What is the benefit to me when my spouse/domestic partner is covered by both their plan and our plan?

What should I consider when deciding whether or not to double cover my spouse/domestic partner?

What do I need to do if my spouse/domestic partner becomes eligible for other employer coverage outside of Fred Hutchinson Cancer Center's open enrollment period?

If my spouse/domestic partner loses their employer coverage, may they be added to our plan?

What if my spouse/domestic partner is not employed or does not currently have coverage available through their employer?

What if my spouse/domestic partner is retired and eligible for Medicare?