Eligibility
Who Is Eligible for Benefits?
To be eligible for Waters benefits, you first have to be either a Waters employee or the dependent of a Waters employee. (Remember that dependents aren’t just children! When you’re talking about benefits, dependents include spouses and partners. See the full list of dependents below.) Now, assuming you are a Waters employee (or the dependent of one), here are some specific requirements for benefit eligibility.
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Employee Eligibility
To qualify for benefits as a Waters employee, you need to be:
A regular, full-time employee who works at least 37.5 hours a week
A regular, part-time employee who works at least 20 hours a week
(Exception: Any Waters employee is eligible to participate in the 401(k) Plan, regardless of work hours.)
And, just to be clear, you are NOT eligible to receive Waters benefits as an employee if you are:
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Dependent Eligibility
If you, as a Waters employee, are eligible for benefits, then eligible dependents include your:
Legal spouse, including same-sex spouses and common-law spouses
Domestic partner (same or opposite sex)*. (If you weren’t aware, this is more than just living together. See the Domestic Partner Eligibility Requirements and tax implications at WatersBenefitsNow.com for details.)
Divorced or legally separated spouse until either of you remarries, if a legal judgment or court order requires this coverage.There are exceptions though to exactly which plans they are eligible for. Your divorced or legally separated spouse is not eligible for spouse life insurance or family AD&D, nor are their health care expenses eligible under the Health Care Flexible Spending Account or Health Savings Account.(Note that, if either of you remarries, or a court order exists that requires you to continue to cover your ex-spouse under your employer’s health plan, please contact Waters Benefits Now at 1-866-994-5111 for options.)
Dependent child under age 26*, including:
Foster children
Adopted children
Children of your covered spouse, covered civil union partner, or covered domestic partner
Children of your child (aka your grandchildren), if your child is an eligible, covered dependent on your plan
Unmarried child of any age who is mentally or physically incapable of self-care*. (You may need to confirm your child’s eligibility by providing medical or other information.)
A few FYI’s to keep in mind when it comes to covering dependents:
If your spouse/partner or child dependent are also a benefits-eligible Waters employee, they cannot be a covered dependent of yours for Spouse or Child Life Insurance, since they already will have their own Life Insurance through Waters.
If you enroll a child who cannot be claimed as a dependent on your taxes, Waters or the health plan may also request some supporting documentation to confirm their relationship to you.
Certain benefits, such as pretax HSA Accounts, can’t be used to pay for out-of-pocket expenses for dependents who aren’t your tax dependents. (For assistance, call the Waters Benefits Now Call Center at 1-866-994-5111.)
For most basic plans, Waters pays the majority of the premium
costs for your plan. In most situations, the money Waters spends on your behalf is untaxed by the federal government. However, if you cover a domestic partner, civil union spouse, or their eligible dependents, the IRS considers Waters share of those costs to be taxable income.
For Example
When Hannah signed up for her benefits, she opted to cover her domestic partner, Michelle. Adding Michelle to the plan increased the total premium cost – not just for Hannah, but also for Waters. (Not to mention, unlike Hannah’s regular premium, the extra portion covering Michelle comes out of Hannah’s paycheck AFTER taxes; it’s post-tax.) Remember, Waters pays about 85% of the medical premium costs, on average. The premium cost you are responsible for–the one you see listed by a plan–is what’s left after Waters has paid its share.
When it comes time to calculate taxes, the IRS will take that extra amount Waters paid for insuring Michelle, and add that number to Hannah’s income. That total will be the amount the IRS uses for calculating how much tax Hannah owes. So if Hannah makes $50,000 this year, and Waters has to pay an extra $5000 to cover Michelle that year, the IRS will tax Hannah as though she made $55,000.
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Life Insurance: Coverage that pays out to your beneficiaries
in case of your death.
AD&D: Coverage that pays out in the event of your death or a permanent loss related to injury.
Health Savings Account: Learn more about setting aside money in an HSA to pay medical costs throughout the year.
General Purpose Health FSA: Set money aside to help pay your out-of-pocket medical, prescription, dental, and vision costs.
Limited Purpose Health FSA: A more limited version of the FSA, that lets you set money aside to help pay your out-of-pocket dental and vision costs. (NOT medical or prescription costs, though.)
Special Enrollments: If the status changes for any of your dependents, or if you add new dependents (through birth, marriage, etc.), you have 30 days to request a Special Enrollment so you can sign them up for (or waive) appropriate benefits.
Now, if you have someone you want to cover who isn’t on that list above, chances are they aren’t eligible. Here’s a list of family and personal relations people sometimes want to cover, but who don’t qualify as dependents:
Of course, special rules may apply for certain situations. For instance, when there’s a court order addressing medical coverage, a former spouse, adopted dependent children, legal guardianship of dependent children, or when a family member has a different last name than you.
It probably goes without saying that enrolling someone who is not qualified as a dependent is considered insurance fraud. No one expects you would do something like this. However, if you were to take part in this kind of fraud, possible consequences could include severe corrective action-up to and including:
Termination of employment
Repayment of premium costs for non-qualified persons
Cancellation of coverage and repayment of costs for services, back to the date they were first enrolled
Permanent prohibition from enrolling in any benefit plan at Waters, or anywhere else.
If you’re not sure someone you want to cover qualifies as a dependent, please contact the Waters Benefits Now Call Center at 1-866-994-5111.
