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Â鶹ӰԺ State is self-insured. This means health care claims are paid directly by Â鶹ӰԺ State. The fee is a way we can keep our premiums affordable, and to continue offering great health insurance options. When coverage is granted to a working spouse or domestic partner with access to their employer’s health care plan, this creates higher costs for employees at Â鶹ӰԺ State. The working spouse/domestic partner fee helps to absorb some of the health care costs that Â鶹ӰԺ State will incur instead of your working spouse’s employer.

The Working Spouse/Domestic Partner Fee applies:

• If your spouse or domestic partner is working full-time at an employer who offers group health insurance, but has declined coverage and wants to remain on the Â鶹ӰԺ State health plan.
• If your spouse or domestic partner is enrolled in Medicare, but is still actively working at their employer, who offers group health insurance.
• If your spouse or domestic partner is offered coverage for any time period throughout the year with their employer, and you choose to continue their coverage under the Â鶹ӰԺ State health plan.

The Working Spouse/Domestic Partner Fee may be waived if your spouse/domestic partner meets one of the following criteria:

• If you and your spouse are BOTH employed at Â鶹ӰԺ State and are both covered on the Â鶹ӰԺ State health plan under either you or your spouse/domestic partner’s coverage.
• If your spouse/domestic partner is enrolled in Medicare, but is currently covered on your active employee Â鶹ӰԺ State health plan.
• If your spouse/domestic partner is a retiree and is not actively working.
• If your spouse/domestic partner is employed part-time.
• If your spouse/domestic partner is employed part-time and has NO access to health coverage.
• If your spouse is self-employed and has NO access to an employer-sponsored health care plan.

Yes.

Yes. Your spouse's loss of coverage would be considered a qualifying event, which means they could be enrolled in the Â鶹ӰԺ State plan within 31 days of the termination of benefits, and you would not be required to pay the working spouse fee. Written documentation from your spouse's or domestic partner’s employer regarding their loss of coverage would be required, along with an updated copy of the following.

• Affidavit of Spousal/Domestic Partner Insurance Status form (PDF) 
• Change of Information Benefits form (PDF). 

These must be submitted to the Employee Benefits office.

Yes, they can remain on your Â鶹ӰԺ State health plan, and you will be eligible to waive the working spouse fee.

Yes. Working spouses/domestic partners can be added throughout the year.

No, the working spouse fee applies only to the MEDICAL plan.