Useful Links
& Forms

Health & Welfare SPD

• Article V - Dependent Eligibility

Pension SPD

• 10.4 Lump Sum Death Benefits
• 10.5 Beneficiaries

Forms

• Declaration of Domestic Partnership For Enrollment and Eligibility
• Enrollment Form for Active Members

Life Event - Domestic Partnership

Domestic partner rules apply to the Health & Welfare Plan only. General Beneficiary designation rules apply to all Plans.

Plan Checklist

• "Domestic Partner" is defined as a spousal equivalent relationship sanctioned by the laws of a state, county, city or other municipality. Domestic Partners shall become eligible on the first day of the month following the month the Plan Office receives proof of Domestic Partner status in the form of an official certification of registration of domestic partnership and either 1) an affidavit of "dependency" for tax purposes, or 2) advance remittance of at least six months of taxes the Plan Office determines are due on the additional imputed taxable income to the member, including the employer's portion of such taxes. The Plan will not be responsible for any taxes, tax-related penalties or interest imposed on the member as a result of providing Domestic Partner coverage.

Also Consider...

Contact the Plan Office if you have any questions.