Health Plans - Health Care Dependent Eligibility Criteria

Eligibility Verification & Reporting

Verification of Eligible Dependents

Random audits of dependents of the entire population may be conducted annually.
Verification process for all dependent children between the ages of 19 and 25 will take place annually.

In either case, documentation showing eligibility must be provided to Benefit Express. Documentation includes: a copy of the most recent tax return, proof of residency and a copy of a court order or divorce decree where applicable.

Failure to comply will result in cancellation of health care coverage. If a dependent becomes ineligible, in order to reinstate health care coverage, documentation showing eligibility must be provided.

Reporting Eligibility Changes

You must notify Benefit Express at 888-456-7800 within thirty (30) days of any event (e.g. marriage, birth of a child, divorce) affecting your eligibility or the eligibility of your dependents.

The Corporation shall have the right of determining eligibility of a spouse, dependents and sponsored dependents consistent with the provisions of the Plan. TOP

Eligibility Criteria

You, your spouse, and your dependents may be eligible for health care coverage provided by DaimlerChrysler Corporation (the "Corporation" or the "Company").

If you are eligible, the following individuals are also eligible for Corporation provided health care coverage if they meet the corresponding eligibility criteria: your spouse, children of the primary enrollee or of the spouse of the primary enrollee, children related by blood or marriage, your same-sex domestic partner, and sponsored dependents.

Dependent Children Eligibility Criteria

Children of the primary enrollee, or the children of the spouse or eligible domestic partner of a primary enrollee, are eligible for dependent health care coverage if the following eligibility rules are met:
- Children include the employee’s or retiree’s:
  - Natural Child;
  - Stepchild;
  - Legally adopted child;
  - Child placed for legal adoption under age 18;
  - Child by legal guardianship;
- The child must not have reached the end of the calendar year in which he/she turns age 25 unless the child was determined to be totally and permanently disabled prior to the end of such year;
- The child must be unmarried;
- The child must live with the primary enrollee or surviving spouse as a member of the household, or the primary enrollee must be legally responsible for providing health coverage for the child through a divorce decree, court order, or Qualified Medical Child Support Order (QMCSO). Full time students are considered to be living with the enrollee while they are away at school; and
- The primary enrollee must be able to legally claim the child as an exemption, under section 151 of the Internal Revenue Code, for Federal Income Tax purposes. The Internal Revenue Code Regulations defining a “dependent” determine whether or not the primary enrollee can legally claim an exemption. Guidelines for claiming an exemption can be found in IRS Publication 501. An exception may be made if the primary enrollee is legally responsible to provide health care coverage for the child through a divorce decree, court order or Qualified Medical Child Support Order (QMCSO).
Children related by blood or marriage (e.g., grandchild, niece or nephew)
- Who reside with you and are principally supported by you;
- Who were reported as dependents on your most recent federal income tax return; or
- Qualify in the current year for dependent status as defined in the Internal Revenue Code, and for whom you provide principal support.

Coverage will not be provided for a child:

Who has reached the end of the calendar year in which the child became age twenty-five (25);
Who first becomes totally and permanently disabled after the end of the calendar year in which the child reaches age twenty-five (25);
Who was eligible for coverage as a totally and permanently disabled child, recovers, and again becomes disabled after the end of the calendar year in which the child reaches age twenty-five (25);
Who was not eligible for coverage at the time of disability;
Who was born out of wedlock and does not reside with you.
This exclusion is voided if there is a Qualified Medical Child Support Order (QMCSO) which requires the child be provided health care coverage. TOP

Same-Sex Domestic Partner Eligibility Criteria

Are the same sex;
Have shared a continuous committed relationship with each other for no less than six (6) months, intend to do so indefinitely, and neither has any such relationship with any other person;
Are jointly responsible for each other's welfare and financial obligations;
Reside in the same household;
Are not related by blood to a degree of kinship that would prevent marriage from being recognized under the laws of their state of residence;
Reside in a state where marriage between persons of the same-sex is not recognized as a valid marriage, or, if residing in a state which recognizes same-sex unions, enter into such union as is recognized by the state;
Each partner is over age eighteen (18) of legal age, and legally competent to enter into a contract; and
Neither is married to a third party. TOP

Same-Sex Domestic Partner Health Care Enrollment

Because of IRS regulations, enrollment of a same-sex domestic partner is likely to result in tax consequences to the employee since state and federal laws do not currently recognize a same-sex partner as a legal "spouse". A same-sex domestic partner will qualify as an IRS eligible "dependent" only if:

More than half of the partner's support for the year comes from the employee;
The partner earns less than the IRS exemption amount; and
The partner is a member of the household maintained and occupied by the employee.

If the same-sex domestic partner does not qualify as an IRS eligible dependent, the employee will be required to pay income taxes on the value of the coverage. The Corporation will assume that a same-sex domestic partner who is enrolled for coverage is not an IRS eligible dependent and will impute income for the coverage unless the employee can document the partner is claimed on his or her tax return. Employees are encouraged to seek the advice of their tax advisor before electing this coverage.

To enroll a same-sex domestic partner for health care coverage or if a domestic partner relationship ends you must contact Benefit Express at 888-456-7800. TOP

Same-Sex Domestic Partner COBRA Coverage

When same-sex domestic partners are no longer eligible for Corporation-provided health care coverage, they do not qualify for COBRA coverage under the federal government's regulations regarding COBRA continuation of coverage.

In addition, certain alternative plans may not provide COBRA-like coverages. Benefit Express will administer Corporation-provided COBRA-like cash pay continuation of coverage based upon eligibility rules and payment arrangements as apply under COBRA for persons who no longer meet the eligibility rules.

Note: Current retirees may not cover same-sex domestic partners. However, employees who retire while covering a same-sex domestic partner and/or same-sex domestic partner's eligible children will be permitted to cover those dependents under the Corporation's health care plan during retirement. No new same-sex domestic partner dependents can be added after retirement. TOP

Sponsored Dependent Eligibility Criteria

You may also enroll your eligible sponsored dependents for HSMDH (but not vision and dental) coverage. Sponsored dependents are individuals other than your spouse or eligible dependent children who either are related to you by blood or marriage, or who life in your home (e.g., a grandchild, an aunt or parents).

Sponsored dependents who are not citizens of the United States must reside in the United States for one (1) full year and must be legally entitled to remain in the United States indefinitely before becoming eligible for coverage. TOP