Superior Officers Council City of New York Police Department

Active Member Dependent Benefits

Who Are Eligible Dependents

Family members eligible for benefits under the member are:

Documentation is required for all dependents. Members must provide copies of Marriage Certificates, Birth Certificates, Registration of Domestic Partnership, Adoption Papers, Court Order Legal Guardianship, proof of Full-Time Student Status and/or medical documentation of disability, when applicable. Fax to the SOC at 212-406-3105 or mail to to SOC at 233 Broadway, Suite 1801, New york, NY 10279.

Definitions

Domestic Partnerships

A domestic partner is defined as a "person, eighteen years of age or older, who is not married or related by blood to the employee or retiree in a manner that would bar marriage in the State of New York, who has a close and committed personal relationship with the employee or retiree, who lives with the employee or retiree and has been living with them on a continuous basis, and who, together with the employee or retiree, has registered with the city clerk as a domestic partner of the employee or retiree and has not terminated the domestic partnership." Employees can obtain details concerning eligibility, enrollment, and tax consequences from the agency payroll or personnel office or from the Office of Labor Relations, Domestic Partnership Liaison Unit at 212. 306.7336.

Dependent Children

Eligible dependent children include natural children, legally adopted children, and children for whom you have court appointed guardianship or legal custody and who are unmarried and live with you permanently.

For the purpose of the Dental and Optical Benefit, eligible dependent children are covered to the last day of the month of their 19th or 23rd birthday (must be a full time student after age 19).

For the Prescription Benefit, dependent children are covered until December 31st of the year they reach the age of 19 or 23 years (full time student) or until the end of the semester in the year they graduate which ever comes first.

Step-children

Effective January 1, 2011, the SOC will provide benefit coverage for members' stepchildren. To enroll your stepchild (ren) you must complete the "Affidavit of Dependent Stepchild (ren)" and submit to the SOC Health and Welfare Fund Office. Coverage will only be extended to stepchild(ren) who meet the specific criteria outlined on the "Affidavit of Dependent Stepchild (ren)" .

Developmentally Disabled or Physically Handicapped Children

Dependent coverage is also extended to any unmarried child, regardless of age, who is incapable of self-sustaining employment by reason of a mental or physical handicap and who becomes so prior to attainment of age 19 and who resides with and is wholly dependent on the covered member for financial support. You must submit proof of your dependent child's incapacity to the Fund office 31 days after the date he attains the age at which his coverage would otherwise terminate or within 31 days after you are notified of his termination of eligibility, whichever is later. Proof of the continued existence of such incapacity shall be furnished to the Fund office from time to time at its request.

Adult Children Up to Age 26

Effective January 1, 2011, Federal Health Care Legislation requires essential health benefits (includes only the prescription drug coverage provided by the Fund) coverage be extended for current active members' qualified adult child(ren) up to age 26 regardless of their financial dependency on the active member, residency with the active member, martial status, student status, or employment status. Coverage will not be extended for adult children up to age 26 who are eligible for other coverage through another employer sponsored plan, whether it is the adult child's employer or his/her spouse's employer. When a child of an active member turns 26, their coverage will end the day prior to their birth date. (For example, child turns 26 on July 17, 2011, the last day the plan must cover the child is July 16, 2011.)

If your adult child(ren) previously lost Fund prescription drug plan coverage because he/she "aged out", and he/she is not yet 26 years old, you will have an opportunity to enroll your child(ren) during the period of January 1, 2011 through February 28, 2011 with an effective date of January 1, 2011.

To enroll your adult child(ren) up to age 26, you must complete the "Request for Coverage of Adult Children to Age 26" (click to download), and submit to the Superior Officers Council Health and Welfare Fund Office.

Student Proof

Student proof is required each semester once the dependent child turns 19 years of age. Acceptable proof is a letter from either the Bursar's or Registrar's Office stating full time student status, or a bill outlining a full time course load. Proof for the spring semester is valid from February 1st to August 31st and proof from the fall semester if valid from September 1st to January 31st.

Adding a Dependent

To add a spouse, domestic partner, or child, the member may drop off, mail, email maryann@nypdsoc.com or fax to 212.406.3105, a Marriage Certificate, Domestic Partnership documentation, adoption papers or proof of legal guardianship.

Losing Eligibility and Reinstatement

If a participant becomes ineligible for benefits for any reason under the Plan during the plan year and then subsequently becomes reinstated and eligible for benefits under the Plan at a later date, that participant will continue to receive benefits at the same level the participant was receiving benefits as of the day the participant became ineligible.

Notification of your Social/Family Status

It is important you immediately notify the Fund Office of any change in your social/family status (adding dependents due to marriage, domestic partnership, birth, or adoption of a child, or dropping dependents due to death, divorce, legal separation, termination of domestic partnership or a child reaching an ineligible age or losing full-time student status).

If it is found that a participant or beneficiary fails to submit the requested information on the Statement of Dependency, fails to notify the Fund Office immediately following a change in that participant or beneficiary's social/family status, change in student status, makes a false statement, or furnishes fraudulent or incorrect information, the authorized representatives of the Fund Office, Trustees, or any of their designees in their sole and absolute discretion reserve the full authority to deny, suspend or discontinue the participant or beneficiary's benefits provided under the plan at any time and for any length of time. Furthermore, a failure to notify the Fund Office of a change in social/family status will leave the participant or beneficiary personally responsible for all expenses/costs incurred by the Fund, retroactive to the effective date of the assigned coverage whereby the dependent was ineligible for benefit coverage under the Plan, as a result of administering benefits to members and dependents in this fraudulent situation.

Any participant or beneficiary who willfully and knowingly engages in an activity intended to defraud the Plan will face loss of coverage under the Plan, will be held personally liable to the Fund for all costs/ expenses incurred by the Fund, and will be subject to all other legal remedies available to the Fund at that time.

Keep the Plan Informed of Changes

In order to protect yours and your family's rights, it is imperative that all participants and beneficiaries keep the Fund Office up-to-date of their current family/social status, address, telephone number, and e-mail address. You should also keep a copy, for your records, of any notices or correspondence you send to the Fund Office.