Human Resources Information Systems
Tel: 780-5628 - Fax: 780-5554 - Email: HRIS
© 2003 USM - HRIS
A Member of the University of Maine System
U N I V E R S I T Y O F S O U T H E R N M A I N E
POLICY #: 102.12
SUBJECT: Domestic Partners/Benefits Eligibility
APPLIES TO: AFUM Unit members and Non-Represented Employees
ISSUED BY: University of Maine System
EFFECTIVE DATE: 10/1/96
REVISION:
In accordance with University of Maine System policy
approved by the Board of Trustees, an eligible employee may
register a domestic partner for purpose of receipt of University
benefits; health insurance, bereavement or disability leave,
tuition waiver and use of University facilities. For the purpose
of this policy, a domestic partner who is registered and meets
the eligibility criteria as further outlined is considered
equivalent to a spouse for purpose of benefits.
ELIGIBILITY CRITERIA
Registration of domestic partner requires filing of
affidavit certifying the domestic partner meets the following
criteria.
1) Partners are each at least eighteen (18) years of age,
and are mentally competent to contract.
2) Partners are not married to anyone and are prohibited From legally
marrying each other in the State of Maine.
3) The partners are not related by blood to a degree which
would prohibit marriage in the State of Maine.
4) The partners reside together and have resided together for at least
two (2) years.
5) The partners are financially interdependent. (Evidence of
financial interdependence will be required.)
6) Misrepresentation of information in the affidavit will
result in disciplinary action up to termination of
employment, and an obligation to repay the benefits received.
7) The employee will notify the University by completion of a form
when domestic partnership ends.
PROCEDURAL REQUIREMENTS
The University of Maine System Affidavit of Domestic
Partnership form shall be completed by the employee and the
domestic partner. The signatures of both must be notarized. The
employee must also certify for partner certification as a tax
qualified dependent.
At the time of submission of affidavit, the employee shall
be required to demonstrate evidence of joint responsibility. The
following items may demonstrate joint responsibility.
A) Domestic partnership agreement or relationship
contract.
B) Joint mortgage or joint ownership of primary
residence.
C) Two of:
Joint Ownership of Motor Vehicle
Joint Checking Account
Joint Credit Account
Joint Lease
D) The domestic partner has been designated
as a beneficiary for employee's will, retirement,
contract or life insurance.
Copies of documents are to be submitted along with affidavit,
and must be certified by notary as true and original documents.
The employee must indicate at least two items of financial
interdependence. The partners must check at least two of the
major items A,B,C or D, and in subpart C, must indicate two of
the four items.
SUBMISSION OF AFFIDAVIT
Submission of affidavit is completed at the Benefits
Office, Human Resources, University of Southern Maine. Upon
submission, the affidavit will be reviewed for accuracy and
completeness and and notarization of the affidavit, and
documentation of evidence of financial interdependence.
Notarization services are not provided.
HEALTH COVERAGE
At time of submission of affidavit, the employee may also
add the partner to health programs. The usual and customary
enrollment forms are applicable.
TUITION WAIVER
Tuition waiver requests are filed through regular processes
and procedures. Eligible employees would submit "Request for
Dependent Tuition Waiver".
DISABILITY LEAVE/BEREAVEMENT LEAVE
Requests for eligible leave benefits has not changed. The
employee may make request of his/her immediate supervisor. A
supervisor may verify eligibility by contacting the Benefits
Office.
TAXATION OF BENEFITS
If a domestic partner is not a dependent of the employee
as defined by the Internal Revenue Service, the value of health
benefits and tuition waiver for the partner constitute taxable
income for the employee. Generally, a partner is not a tax
qualified dependent unless the employee provides at least half
of the partner's support and the partner has lived in the
employee's household for the entire tax year.
Employees are advised to consult with tax advisor if
certifying that a partner is a tax qualified dependent. If the
partner is a tax qualified dependent, health plan contribution
and benefits will be processed in accordance with University
procedures.
If the domestic partner of the employee is not a
tax qualified dependent, the share of the health
insurance premium contribution which is for
the partner's coverage must be paid on an after tax basis. In
addition, the fair market value of the coverage constitutes
taxable income for the employee, and is subject to withholding
for income tax and FICA.
If an employee receives dependent tuition waiver for a
partner who is not a tax qualified dependent, the value of the
waiver is also taxable income.
TERMINATION OF DOMESTIC PARTNERSHIP
As provided in the Affidavit of Domestic Partnership, the
employee is required to notify the University in writing within
thirty (30) days of any termination of domestic partnership. A
Statement of Termination form is provided. The written termination
statement affirms that a copy of the termination statement has been
mailed to the other partner. The original is to be filed at
the Benefits Office, Human Resources, University of Southern Maine.
A domestic partner is not eligible for continued health coverage
under COBRA upon termination of the domestic partnership.
FORMS
Affidavit forms and Statement of Termination are available
through the Benefits Office.
These pages are designed and
maintained by
Human Resources Information
Systems
Tel: 780-5628 - Fax: 780-5554 - Email: HRIS
© 2003 USM - HRIS
A Member of the University of
Maine System