Citi Benefits Handbook
When you add a spouse/partner or new dependent to your coverage, you will be required to submit proof of eligibility for the coverage (for example, a marriage license or birth certificate). If proof is not received by the deadline stated in the dependent verification package, the spouse/partner or dependent(s) will be dropped from coverage.
Your eligible dependents must be U.S. citizens or legal residents and generally are:
- Your lawfully married spouse or your common-law spouse, if you live in a state that recognizes common-law marriages, or your civil union partner, if you live in a state that recognizes such partnerships; if you are legally separated or divorced, your spouse/partner is not an eligible dependent unless mandated by state law; at any time, you cannot cover more than one person as your spouse/partner;
- Note: Because civil union partnerships are recognized by certain states and generally provide the same protection as marriage, civil union partnerships are not subject to the domestic partnership certification process. However, under federal law, civil union partnerships are subject to the same tax treatment as domestic partnerships. Alternatively, if your domestic partnership is registered in any state or under any local government authority authorized to provide such registration, documentation of such registration will be accepted as proof of your domestic partnership, without satisfying the listed requirements for non-registered domestic partners.
- Your domestic partner;
- Your domestic partner's eligible dependents;
- Your children under the age of 26* (dependent children are covered through the end of the plan year in which they turn 26, regardless of whether they are full-time students) who are:
- Your biological children;
- Your legally adopted children;
- For purposes of coverage under the Plans, adopted children will be considered eligible dependents when they are lawfully placed in your home for adoption or when the adoption becomes final, whichever occurs first.
- Your stepchildren; and
- Any other children for whom you are the legal guardian in accordance with the laws of the state in which you reside.
You can cover your disabled child beyond age 26 if he or she was covered under the Plans before age 26 and while covered became incapable of self-sustaining employment due to a disability, in which case the eligible dependent may be eligible for coverage beyond such age.
You may also cover your disabled adult child age 26 or older when you begin employment with Citi and you enroll him or her when you are first eligible to do so. You must have a letter from the Social Security Administration (SSA) declaring your child as disabled; if you do not have such a letter, your Citi health plan will evaluate the child before adding him or her to your health care coverage.
Note: Not all HMOs cover civil union partners/domestic partners and/or their children. For more specific information, contact your HMO directly.
*Coverage generally will remain in effect through December 31 of the year in which the child reaches the maximum age of 26. However, for some HMOs, coverage ends on the last day of the month in which the child reaches the maximum age. For specific information, contact your HMO directly. For more information on when coverage ends, see "When Coverage Ends."
State laws apply only to fully insured plans. See the list of fully insured plans in the Medical subsection of the Health Care Benefits section of this Benefits Handbook.
No dependent can be covered under these Plans as both an employee and an eligible dependent or as an eligible dependent of more than one employee.
Note about disabled children: If your eligible dependent child is permanently and totally disabled as defined for purposes of obtaining Social Security benefits and (a) is covered under the Plans before reaching the applicable maximum age as described above, or (b) you enroll this dependent within the first 31 days of your eligibility under the Plans, this child may continue to be considered an eligible dependent under the Plans beyond the date his or her eligibility for coverage would otherwise end. You must provide written proof of this incapacity to the Claims Administrator within 31 days after the date eligibility would otherwise end or as requested thereafter. This eligible dependent must still meet all other eligibility qualifications to continue coverage, including, but not limited to, continuing to be permanently and totally disabled.