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If your group has domestic partner coverage, the following applies.
Domestic Partnership, for either same-sex or opposite-sex partners, is defined as:
| Two people, both eighteen (18) years of age or older, who are not related by blood in a manner that would legally prohibit their marriage. Neither person is married. Neither person has had another domestic partner within the last six (6) months.|
| The persons have been living together on a continuous basis for at least six (6) months. The persons intend to continue living together indefinitely. Proof of cohabitation must be submitted. Proof includes a driver’s license, tax return, or other sufficient proof as determined by Empire.|
| The persons are registered as domestic partners, when registration is available; or the two persons submit an affidavit of domestic partnership. The registration statement or affidavit must be submitted to verify the domestic partnership.|
| The financial interdependence of the domestic partners is established by evidence of two or more of the following, proof of which must be submitted: |
a joint bank account
a joint credit or charge card
a joint obligation on a loan
joint ownership of a residence or other real estate
joint tenants on a lease or shared rental payments of residence or other property
a common household and shared household expenses (e.g., grocery, utility, or telephone bills)
joint ownership of a vehicle or major items of personal property
wills naming each other as executor and/or beneficiary
the partner is the designated beneficiary in the other’s life insurance policy
the partner is the designated beneficiary in the other’s retirement benefits plan
mutual grant of authority as healthcare proxy
mutual grant of durable power of attorney
status as authorized signatory on partner’s credit card, charge card or bank account
joint ownership or holding of investments
shared household budget for purposes of government benefits
status of one as payee of the other’s government benefits
joint responsibility or shared expenses for child care
affidavit of creditor or other entity able to testify to partners’ financial interdependence
| The persons agree to file a termination statement in the event of termination of the domestic partnership. |
The domestic partnership is verified by the submission of the three (3) categories of proof described in the points above.
Note: Empire has determined that members who are covered as domestic partners, and would not be eligible for continuation of coverage under COBRA, are eligible for continuation of coverage under New York Sate Law and may elect to continue their coverage.
Dependents of Domestic Partners
The definition of “Children” under the Contract or Certificate will include children of a domestic partner who are otherwise eligible for coverage under the Contract or Certificate.