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Affidavit of Domestic Partnership |
| Dependent Child Certification | |
| Statement of Termination of Spousal Equivalency |
Coverage for domestic partners and children of domestic partners is offered on the same terms as for other City employees. To qualify, you must be benefit eligible, satisfy certain criteria and have been in the relationship for 6 months or more and complete an Affidavit of Domestic Partnership available in Human Resources. Benefits included are Health Insurance, Dental Insurance, Family and Medical Leave, and Sick and Bereavement Leave.
More about Domestic Partnerships
What is a domestic partner? Also known as a "spousal equivalent", a domestic partner is a person of the same or the opposite sex with whom an employee has a long-term intimate and committed relationship. Both parties must be 18 years of age, competent to contract and be each other's only mate. Neither partner can be married to anyone else and cannot be blood-related to the degree that legally prohibits marriage. Domestic partners must live together at the same permanent residence, be jointly responsible for each other’s common welfare, and be financially interdependent.
How would I qualify for domestic partner benefits? In order to qualify for benefits you must be benefit eligible, satisfy the criteria listed above and have been in this relationship for 6 continuous months or more. The employee must not have signed a domestic partner affidavit with any other partner within the last 6 months. Both you and your partner would need to sign an affidavit to this effect and be able to provide proof of a financially interdependent relationship such as a joint bank account, joint lease or mortgage or joint ownership of property.
What benefits are available for domestic partners? Coverage for domestic partners and children of domestic partners are on the same terms as for other City employees: Health Insurance, Dental Insurance, Family and Medical Leave, and Sick and Bereavement Leave.
What is the cost of the coverage? The cost for health and dental insurance will be consistent with our current 2-person and family rates; however, because domestic partners are not recognized by the Internal Revenue Service, the weekly deductions for domestic partners and their children must be taken on a post-tax basis. If you currently carry pre-tax benefits for your children, that portion of the benefits would remain pre-tax.
The City's contribution to health insurance for the domestic partner and children of the domestic partner is considered imputed income and will be calculated into the employee's gross earnings as taxable wages.
How to Enroll: First complete the Domestic Partner Affidavit and attach the completed enrollment forms for which you are requesting coverage. Return them to Janice Kimball or Elizabeth Morgan in Human Resources. If you meet the domestic partner criteria, the benefits staff will approve your request and process the enrollment forms for coverage effective the first of the following month after approval of the affidavit.
Misrepresentation of information given in the affidavit may result in disciplinary action and domestic partners and the child/children of the domestic partner will not be offered continuation of coverage under COBRA.