Benefits Information


Benefit Policies

The City of Seattle has several benefits policies related to employee coverage.
You will find the following: a description of eligibility for medical, dental, vision, life, accidental death and dismemberment, and long-term disability coverage. We also have included information on the City's leaves and holiday policies, and the benefits exceptions policy for our self-insured medical plans.

Eligibility

If you are a regularly appointed employee in a full or part-time position (scheduled to work at least 80 hours per month), you are eligible to participate in the following plans:

  • Medical
  • Dental
  • Vision
  • Group-term life
  • Accidental death and dismemberment
  • Long-term disability
  • Health care flexible spending account
  • Day care flexible spending account
  • Deferred compensation
  • Employee assistance program plans

The following family members are eligible to participate in the medical, dental, vision, supplemental life insurance, accident coverage, and EAP programs:

  • Your spouse under federal or state law (unless legally separated)
  • Your domestic partner, if both of you:
    • Share the same regular and permanent residence;
    • Have a close personal relationship;
    • Are jointly responsible for "basic living expenses"
    • Are not married to anyone;
    • Are each 18 years of age or older;
    • Are not be related by blood closer than would bar marriage in the State of Washington;
    • Were mentally competent to consent to contract when the domestic partnership began; and
    • Are each otherís sole domestic partner and be responsible for each otherís common welfare.

  • Your children under age 26*, including:
    • Your biological child
    • Your child for whom you have a qualified medical support court order to provide coverage
    • Your legally adopted child, including any child placed with you for adoption
    • Your step-child (your spouseís child)
    • Your domestic partnerís child
    • Your child, for whom you are the court-appointed legal guardian

*Coverage may continue for a handicapped/incapacitated child if the child becomes disabled prior to the limiting age. The child must depend chiefly on you for support and maintenance, and a physician must document proof of your childís fully handicapped/incapacitated status.


Change in Eligibility

You may add medical, dental and vision, AD&D (if you are currently enrolled in the employee only plan) and life insurance (if you are currently enrolled in employee supplemental life) coverage for dependents during the plan year if any of these changes in family status occur:

  • Birth, adoption or placement for adoption of a child
  • Loss of a child's or spouse's or domestic partner's eligibility under another health plan
  • Marriage or formation of a domestic partnership
  • An eligible child under age 26 who does not have access to health care through their own full-time employment.

Any change you make must be consistent with the change in family status. Here are several examples:
  • If you adopt a child, you may add coverage for that child (you may add coverage for your other children at that time)
  • If your child loses coverage under your spouseís coverage, you may add this child to your plan
  • If you get married or form a domestic partnership, you may enroll your new spouse or domestic partner and his/her eligible children

Policy on Benefit Exceptions

This policy is adopted by the City of Seattle in accordance with WAC 82-60-034. It explains a new "procedure for requesting an adjudication of disputes or appeals...regarding the payment or denial of any claim for benefits" under our self-insured medical plans.

pdf document icon Benefits Exception Policy

Policy on Benefits Enrollment Deadline Exceptions

The purpose of this policy is to define exceptions to the enrollment period deadlines established by the Personnel Department by which City employees are permitted to make changes to their own coverages in benefit plans governed by Section 125 of the Internal Revenue Code.

pdf document icon Policy on Benefits Enrollment Deadline Exceptions

Page: http://www.seattle.gov/personnel/benefits/library/policies.asp
Printed: 7/24/2014 7:40AM