Who is considered a dependent?

Spouse: The employee’s legally wed spouse as defined by state law, regardless of the spouse’s residency. A copy of the most recent year’s Federal Income Tax return (Form 1040) showing a married filing status must be submitted to SISC in order to add a spouse. All financial information may be blacked out.

Domestic Partner Subject to California Law: SISC eligibility for Domestic Partners is compliant with California law effective 1/1/2020. The law states that if your plan provides benefits for spouses, you must also provide the same benefits for state registered domestic partners (e.g., dependent children, health benefits, COBRA, CalCOBRA, etc.). It is the district’s responsibility to verify domestic partner eligibility and to submit the documentation timely to SISC. Coverage for Domestic Partners when they cannot be claimed on the employee’s Federal Income Tax Return is a taxable benefit. If both parties desire that the domestic partnership be terminated, eligibility ends six months following the filing of the Notice of Termination of Domestic Partnership with the Secretary of State.

Special Note for Domestic Partners: SISC medical plans follow CMS guidelines for Domestic Partners concerning enrollment in Medicare A & B when covered on an active medical plan.

Child/Child of Domestic Partner: A natural child or step-child from birth to age 26; a legally adopted child or a child who is in the process of being adopted; a child for whom the member has legal guardianship to age 18. A child who is in the process of being adopted is considered legally adopted when SISC receives legal evidence of (i) the intent to adopt; and (ii) the member has either: (a) the right to control the health care of the child; or (b) assumed a legal obligation for full or partial financial responsibility for the child in anticipation of the child’s adoption. Proof of eligibility will be required when adding a new dependent for an existing employee and at the time of hire for a new employee. Failure to submit supporting documentation within 30 calendar days of the qualifying event may result in the child or child of a domestic partner being denied coverage.

Disabled Dependent: A disabled dependent may be eligible to continue coverage beyond age 26 if unmarried and a dependent for Federal Income Tax purposes; the member must request a Disabled Dependent Certification form within 30 calendar days of the loss of coverage.