Benefits Eligibility and Dependent Information for Penn State University-Sponsored Employee Benefit Plans
Penn State offers a variety of benefits plans to employees and their eligible dependents. To learn about the benefits for an employee or a dependent, please see the various categories listed below.
Employees who are actively employed in the regular, full-time service of the University are eligible to be enrolled in University-sponsored benefit plans. Coverage becomes effective on the employee’s date of hire, provided the employee has completed the necessary enrollment through the Employee Self-Service Information Center (ESSIC) no later than thirty-one days from his/her date of employment.
Active employees who are participating in University-sponsored benefit plans have the ability to extend coverage to eligible dependents.
Dependent coverage cannot be elected unless the employee is covered under the plan being selected. Dependents are eligible for coverage on the day the employee’s coverage begins, or at the time they become eligible dependents due to an IRS Qualifying Life Event.
Individuals who are considered to be eligible dependents of University-sponsored benefits plans are a spouse (unless legally separated or divorced), dependent children, and individuals under a Qualified Medical Support Court Order (QMSCO).
Penn State requires dependent verification for all dependents who are listed on an employee’s University-sponsored medical, dental, vision and/or tuition discount plans. Penn State’s business partner in the verification process is Aon, who will send a “Request for Verification” packet to the employee’s home address approximately two weeks from the date which dependents are added to the applicable plan. In order for the dependents to maintain coverage on the plans, all forms from Aon must be completed and returned within the time frame specified in the packet. For more information about dependent verification, please visit Dependent Verification.
Spouse Eligibility (including Same-Sex Spouses)
University-sponsored benefits are extended to spouses of Penn state employees.
An employee may cover his/her dependent spouse even if that individual is also an employee of the University. However, no one is eligible to be covered as a spouse or dependent under a University-sponsored plan if he/she already is covered as an employee under a University-sponsored plan or vice versa.
Note: If a spouse who is enrolled in the employee's Penn State medical plan also has coverage available through his/her own employer, the Penn State employee will be assessed a monthly surcharge to cover that person on the employee's Penn State medical plan. For more information see Spousal Insurance Surcharge.
Same-Sex Domestic Partner Eligibility (for currently covered same-sex domestic partners)
Effective 07/01/2015, Penn State will no longer be offering benefits to new employees’ same-sex domestic partners and the children of those individuals. This change is in response to the Supreme Court ruling that legalizes same-sex marriage in all 50 states, as well as to remain consistent with how the University handles benefits for opposite-sex domestic partners who choose to not marry.
The University will allow currently enrolled same-sex domestic partners to remain covered under their current benefits plan(s) through 06/30/2017 without proof of marriage. In order for current same-sex-domestic partners to retain University-sponsored benefits, employees must contact the Employee Benefits office before 07/01/2017 and provide proof of marriage.
Once proof of marriage is provided, existing same-sex domestic partner benefits will continue under the same provisions as for spouses.
No one is eligible to be covered as a spouse, dependent, or same-sex domestic partner under a University-sponsored plan if he/she is already covered as an employee under a university-sponsored plan, or vice-versa.
Note: If a same-sex domestic partner has medical coverage available through his or her own employer, the Penn State employee will be assessed a monthly surcharge to cover that person on the employee’s Penn State medical plan. For more information, see Spousal Insurance Surcharge.
The Affirmation of Same-Sex Domestic Partnership will remain in effect until the same-sex domestic partnership ends or proof of marriage is submitted. It is the employee's immediate responsibility to notify the Employee Benefits Division if a same-sex domestic partnership dissolves by completing and submitting the Termination Declaration of Same-Sex Domestic Partnership, or a legal marriage by submitting a copy of a government–issued marriage license.
Please note that all documentation regarding same-sex domestic partnerships should come directly to the main Office of Human Resources, Employee Benefits Division. All information contained on these documents will be treated by the Employee Benefits Division as CONFIDENTIAL. For assistance with forms related to the Same-Sex Domestic Partnership benefit, please contact the Employee Benefits Service Center at 814-865-1473.
Common-Law Spouse Eligibility
The state of Pennsylvania requires a state license to wed, and therefore does not recognize common-law marriage within the state. Because of this ruling, common-law spouses are not eligible for Penn State benefits. Employees who possess common-law marriage documentation from a state which recognizes common-law marriage should contact the Employee Benefits Office to discuss options for benefits eligibility.
Dependent Child Eligibility
Dependent children are defined as:
A natural child
A child legally adopted
As of 01/01/2017; A child for whom you have legal guardianship over
Or physically or intellectually disabled children who are incapable of self-sustaining employment, regardless of age, provided they are covered prior to the maximum age otherwise applicable (additional information on Disabled Dependent Eligibility is below)
An adult dependent child of an employee is eligible for coverage up to the age of 26. Eligibility is regardless of whether he/she qualifies as the employee’s tax dependent, is a full-time student or is married.
Note: If the adult dependent child of the employee is married, only the adult dependent child of the employee will be eligible for coverage.
Notification is sent to the employee from Highmark approximately 45 days prior to a dependent child turning age 26. This notification includes information concerning a dependent child who may be eligible to continue coverage if that dependent is mentally or physically handicapped, so as to be incapable of earning a living when coverage would normally terminate due to age. After a dependent child is no longer eligible, that dependent child will receive information from Lifetime Benefit Solutions regarding continuation of benefits under COBRA. Additional information regarding COBRA benefits can be found at the following website: /benefits/insurance/cobra/.
Disabled Dependent Child Eligibility
If a dependent child is physically or intellectually disabled and is incapable of self-sustaining employment, regardless of age, that individual may be certified as a disabled dependent for medical coverage beyond the age of 26. In the event that a dependent is still in a disabled status as his/her 26th birthday approaches, please contact the Employee Benefits Division for assistance in certifying that dependent as disabled.
The disability certification will be completed by the medical insurance carrier and communicated to the Employee Benefits Division for applicable coverage.
The newborn child of a covered employee will be covered immediately from birth for the first 31 days if (1) the employee was covered under the Plan on the child's date of birth, and (2) the newborn meets the definition of eligible dependent. Notice to the Plan Administrator does not add the newborn to the employee's medical or dental plan. In order for the newborn to have coverage beyond the first 31 days, the employee must add the dependent to existing coverage via the Employee Self-Service Information Center (ESSIC) within 31 days after the child's birth (even if the employee is currently enrolled in Family or Employee/Child coverage).
Any employee who adds a dependent to his or her Penn State medical, dental, vision and/or tuition benefit coverage will be required to provide documentation which demonstrates that the individual meets Penn State's eligibility criteria for the benefit being selected. The university has partnered with Aon, a consultant who specializes in verification services, to administer the program.
All newly hired employees enrolling in dependent medical, dental, vision, and/or tuition benefit coverage will be required to complete the dependent verification program within 45 days of receiving a verification packet from Aon. Failure to complete the information contained within the packet and submitting it by the return date will result in the removal of the dependents from the employee's benefit plan.
In addition, the verification process is required for any existing faculty and staff who add dependents either during the annual benefits open enrollment period or when experiencing a qualifying event, such as marriage, or the birth or adoption of a child.
Employees who have questions regarding Dependent Verification should contact Aon's Dependent Verification Center at 1-888-223-3338. The center is open Monday through Friday, 8 a.m. - 11 p.m.
Who is an eligible dependent?
For Health, Dental and Vision plans:
- Children up to age 26 (regardless of whether he/she qualifies as the employee’s tax dependent, is a full-time student, or is married). An eligible child is defined as follows: a natural child, a step-child, a legally adopted child, a child for whom you have legal guardianship over, or a disabled child incapable of self-sustaining employment enrolled prior to age 26.
For the Tuition Discount:
- Please refer to policy HR 37, Grant-In-Aid for Dependents for full policy language
How to submit documentation to Aon:
- Online Upload: www.yourdependentverification.com/plan-smart-info
- Secure Fax: 1-877-965-9555
- Mail: Dependent Verification Center, P.O. Box 1414, Lincolnshire, IL 60069-1414
How to view status of verification and access other information:
- Visit – www.yourdependentverification.com/plan-smart-info
- Login Name – PS + Your Dependent Verification ID. (Example PS#######)
- Your Dependent Verification ID can be found at the bottom center of your announcement letter.
- Password – This is your date of birth in mmddyy format. (Example 013168)
- You will be instructed to change your password upon entering the secured site.
Adding and Removing Dependents Mid-Year
Outside Open Enrollment, a dependent can be added or removed only if the employee experiences an IRS-defined life event changes. Changes must be made within 31 days of the date of the life event change. After that time, the employee must wait until the next Open Enrollment.
The following is a summarized list of IRS-defined life event changes:
- Employee's legal marital status changes, due to marriage, divorce, legal separation, or the death of a spouse;
- A change in the number of dependents you cover, due to birth, legal adoption, a qualified medical support court order (QMSCO), or death;
- Changes in employment status of the employee, such as moving from full-time to part-time employment;
- Changes in employment status of a spouse, which can include the ending of their employment, new or different working hours resulting in a change of their employer-sponsored benefits, a benefit change due to a strike, a benefit change for them due to a change in work hours, or if they begin an unpaid leave of absence resulting in a change of benefits;
- A dependent who becomes ineligible for the benefit plan due to age, student status, or by obtaining coverage via other means
Duty to Notify of Ineligibility
The employee is responsible for notifying the University in writing of any change that affects the employee's dependent eligibility, for example, marriage or divorce. An enrollee ceases to be a covered dependent of all employee benefit plans on the date the enrollee no longer meets the definition of a dependent, regardless of when notice is given to the University. The employee is responsible for notifying the University in writing within 31 days to initiate any reduction in premium contribution. Covering a dependent who does not meet the eligibility criteria, intentionally or unintentionally, may result in disciplinary action, up to and including termination of employment.