Healthplan Eligibility

Ohio University offers four basic levels of benefits coverage:

  • employee,
  • employee plus spouse or domestic partner,
  • employee plus one dependent child , or
  • employee plus family (spouse or domestic partner and/or children).

Eligible dependents are defined as:

  • your legally married spouse (husband or wife), if not divorced from you
  • your domestic partner (individuals who share a regular and permanent residence, have a committed personal relationship, can demonstrate financial interdependence, who are not related by blood and who are not legally married or in another domestic partnership) see http://www.ohio.edu/hr/forms/index.cfm for required forms and documentation*
  • each of your children, “Children” includes biological children, adopted children, stepchildren and children placed in your home for the purposes of adoption (for whom you have filed for legal adoption), children for whom an employee is a legal guardian
  • a child over the age limit if the child is a disabled dependent

Qualified Dependents may be added during the annual open enrollment period or in the event of a family status change.

*Medical and dental benefits for a domestic partner are not eligible for the pre-tax deduction from the employee's wages. The Internal Revenue Service has ruled that domestic partners cannot be considered a spouse for tax purposes. Thus, employers are obligated to report and withhold taxes on the fair market value of the domestic partner coverage. Fair market value of the domestic partner coverage is usually defined as the amount the employer contributes to a health plan to cover the domestic partner over and above the amount contributed for single or dependent coverage. For more information view the Tax Information Sheet for Domestic Partner or Policy #40-013.


Dependent Children Coverage

Effective July 1, 2011 for Ohio University employees: Federal Health Care Reform allows parents to cover their children up to age 26 regardless of financial dependence, student or marital status. The coverage for these children will fall within your regular health care premium.

Ohio legislation implemented on July 1, 2010 offers parents the opportunity to purchase healthcare coverage for eligible children between the ages 26 and 28, for an additional premium if the adult child is:

  •  a natural child, stepchild or adopted child of the employee,
  • a resident of the state of Ohio OR a full-time student at an accredited public or private institution of higher education,
  • unmarried
  • if employed, not offered health insurance by their employer,
  • and not eligible for Medicaid or Medicare
AGE PREMIUM ADDITIONAL TAX
Birth to age 26
(Dependent Life coverage limited to age 23 for full-time students)
In regular premium
 
No State or Federal Tax
 

For Unmarried, Full Time Students

AGE PREMIUM ADDITIONAL TAX
Age 26 to 28
(Medical & Prescription only)
 
$50 per month Extended Dependent Premium*
 

No State Tax
No Federal tax through
December 31st of the tax year in which child reaches age 26. Federal tax applied thereafter.

For Non Full Time Student Child (Must meet the bulleted criteria above)

AGE PREMIUM ADDITIONAL TAX

Age 26 to 28
(Medical & Prescription only)

 

$265 per month
Adult Child Premium*

Effective 7/1/14
$292 per month
Adult Child Premium*
No State Tax
No Federal tax through  
December 31st of the tax year 
in which child reaches age 26. 
Federal tax applied thereafter.

 *This premium is in addition to the regular health plan premium.

For more information is available on the Ohio Department of Insurance website: http://www.insurance.ohio.gov/Consumer/Pages/DependentAgeCoverageExpansion.aspx 


Spouse/Domestic Partner Premium

Employee's choosing to enroll their spouse or domestic partner in a health insurance plan are charged an additional $50 Spouse/Partner monthly premium if the spouse is employed and not enrolled in his/her employer's health plan. If your spouse is also employed by Ohio University, the Spouse/Partner premium will not apply.

Employees will be required to answer questions regarding their spouse/partner employer offered coverage. The answers will determine whether the $50 Spouse/Partner Premium will be required in addition to current health care premiums.

1. Is your spouse/partner employed?

   a. If yes, please answer question 2.
   b. If no, the Spouse/Partner Premium will not apply.

2. Does your spouse/partner's employer offer health insurance?

   a. If yes, please answer question 3.
   b. If no, the Spouse/Partner Premium will not apply.

3. Is your spouse enrolled in his/her employer's health insurance?

 a. If yes, the Spouse/Partner Premium will not apply. The employee will be required to provide proof of coverage, such as a health insurance identification card.
   b. If no, the Spouse/Partner Premium will be applied.

If the employment or health insurance enrollment status of a spouse/partner changes during the year, the employee will be allowed to complete new benefits enrollment paperwork in order to stop (or start) the Spouse/Partner Premium.

  18
Faculty
24
Administrators
26
Classified
Spouse/Domestic Partner Premium $33.33 $25.00 $23.08

Premium for Spouses/Partners Both Employed by Ohio University

There are over 400 employees at Ohio University who are married to or a domestic partner of another University employee. Health care premiums for University employees who are married to or are in a domestic partnership with another University employee will be based on the salary of highest paid spouse/partner.
 
These employees can enroll in health insurance at a level of their choosing: Employee; Employee+1; or Employee and family. If an employee chooses a level that includes their University employed spouse/partner, the premiums for the coverage level chosen will be set according to the salary of the highest paid employee.

**AFSCME members: consult your union contract for details regarding your benefit coverages.

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