Peter Gulia Posted July 2, 2013 Posted July 2, 2013 When taking health plan enrollments, do employers ask for marriage certificates? I hope that BenefitsLink’s many helpful readers and writers can help expand my knowledge of current benefits-administration practices. My questions are about whether an employer tries to confirm an employee’s statement that he or she is married. (My questions are not about same-sex marriage, but rather about what (if anything) an employer does to check that an opposite-sex marriage exists.) In a decades-ago era, a new employee when invited to enroll in his or her employer’s health plan, would fill-out a form that asked whether the employee is married and next to that yes-or-no question had a line for writing-in the spouse’s name. If an employee completed the form, the employer enrolled the employee and spouse in the health coverage. No one asked for proof. More recently, some employers understand that differences between employment-based health coverage and other health insurance can lead some employees to present as a spouse someone who is not the employee’s spouse. Leaving aside after-the-fact dependent eligibility audits, what do employers now do at enrollment? Do some employers ask for a marriage certificate? Do they ask for anything else? What does an employer do if the employee does not furnish a marriage certificate or other evidence? On the question of whether the employee is married to the spouse claimed, does an employer decide this “bureaucratically” and rigidly, or does an employer use discretion? If there is some discretion allowed, who has authority to make the discretionary decisions? Do the answers vary significantly between health plans that use health insurance as the means of providing the benefits and those plans that are “self-funded”? Peter Gulia PC Fiduciary Guidance Counsel Philadelphia, Pennsylvania 215-732-1552 Peter@FiduciaryGuidanceCounsel.com
Lou S. Posted July 2, 2013 Posted July 2, 2013 Mine has never asked, small employer. My wife's employer did ask to show coverage about 2 years ago and I believe they requested a copy of marriage cert.
leevena Posted July 2, 2013 Posted July 2, 2013 Very few groups ask for this type of proof, but more and more are beginning to ask for proof of not just spouse, but other dependents. Proof could include marriage certificates, birth, adoptions, domestic partnerships, guardianship and others. If not provided the employer could (and should) deny coverage. If it were me, I would design a process that requries everyone to submit and no exceptions. Once you allow one an "exception" you open up the flood gates. Same answer for self-funded and fully-insured.
Peter Gulia Posted July 2, 2013 Author Posted July 2, 2013 Thanks. Others' experiences? Peter Gulia PC Fiduciary Guidance Counsel Philadelphia, Pennsylvania 215-732-1552 Peter@FiduciaryGuidanceCounsel.com
John Feldt ERPA CPC QPA Posted July 2, 2013 Posted July 2, 2013 When providing service to some larger plan soem years ago (10,000+ participant plans), we required proof of date of birth, proof of marriage, proof of date death, but the level of service being provided would be considered as outsourcing and is generally not the type of service that a typical service provider offers (a TPA). I think that with the small plans (under 100 lives), the employer typically has the burden of obtaining proof of date of birth, marriage and death.
jpod Posted July 2, 2013 Posted July 2, 2013 To the extent FGC's inquiry relates to insured plans, I think the more pertinent question is what do the carriers require, and depending upon the state involved what CAN they require beyond some certification by the employee that the identified spouse/dependent is in fact a spouse/dependent. I have no idea what the answer might be but I would think that if very few employers are demanding substantiation then presumably they aren't obligated to do so as the contract-holders of those group policies.
Guest jims Posted July 2, 2013 Posted July 2, 2013 I work at a large employer and it only does after the fact dependent eligibility audits on a small portion of the population. There is an audit every year - people only have to provide the proof then. Otherwise a new employee doesn't need to provide any documents to cover their spouse. At benefit enrollment, they do acknowledge they follow the company code of conduct - which of course requires honesty and no fraud.
Peter Gulia Posted July 3, 2013 Author Posted July 3, 2013 Thanks to all. John Feldt, for the big employer's plan, what did you do when an employee did not furnish a marriage certificate? Peter Gulia PC Fiduciary Guidance Counsel Philadelphia, Pennsylvania 215-732-1552 Peter@FiduciaryGuidanceCounsel.com
John Feldt ERPA CPC QPA Posted July 3, 2013 Posted July 3, 2013 If no "certificate" of marriage was available, we had fairly short list of acceptable alternative documentation, such as some type of court record, copy of court proceedings, or some other legal documentation that sufficiently proved marital status. When in doubt, we would have the employer make the final decision of whether or not thr proof was sufficient. I do not recall seeing an alternative actually in use for proof of marriage, normally that was for proof of date of birth.
K2retire Posted July 3, 2013 Posted July 3, 2013 As I approach my 30th wedding anniversary, I'm having some difficulty imagining what this documentation might be or where I might obtain it. So far, none of my employers has ever asked for such a thing. Neither has the US Postal Service, from which my husband is retired.
John Feldt ERPA CPC QPA Posted July 3, 2013 Posted July 3, 2013 We keep a copy of our marriage certificate, birth certificates, and our kids birth certificates in a safe deposit box. I would hope that the local court records where you were married would easily be able to provide a copy of your certificate. For example: http://www.co.dallas.ia.us/index.aspx?page=729
Peter Gulia Posted July 3, 2013 Author Posted July 3, 2013 Thank you all for the good help. Peter Gulia PC Fiduciary Guidance Counsel Philadelphia, Pennsylvania 215-732-1552 Peter@FiduciaryGuidanceCounsel.com
ForksnKnives Posted July 5, 2013 Posted July 5, 2013 Marriage records tend to be easier to procure than birth certificates, although when you're after certified copies neither is particularly a pleasure to obtain. I agree with leevena, a consistent approach is really important. http://kielichlawfirm.com
Chaz Posted July 8, 2013 Posted July 8, 2013 It is a trade-off between the possible employee relations issues in requiring marriage and/or birth certificates and the possible fraud in not. I've had different clients take different approaches. Many have found that requiring the employee to certify during open enrollment as to their covered dependents' eligibility upon penalty of death (without requiring other documentation) is sufficient. This also has the benefit of being more administratively efficient.
Peter Gulia Posted July 8, 2013 Author Posted July 8, 2013 Chaz, thank you for the helpful news. Let's hope your client required no more than a penalties-of-perjury statement. Peter Gulia PC Fiduciary Guidance Counsel Philadelphia, Pennsylvania 215-732-1552 Peter@FiduciaryGuidanceCounsel.com
K2retire Posted July 9, 2013 Posted July 9, 2013 Chaz, thank you for the helpful news. Let's hope your client required no more than a penalties-of-perjury statement. Since may employees don't know what "perjury" means, penalty of death is more likely to elicit the desired response!
GBurns Posted July 9, 2013 Posted July 9, 2013 Isn't it against the law to ask a job applicant their marital status? If this is so, then it seems that asking for the marriage certificate of an employee would also be unlawful. Signing an attestation might be okay. George D. Burns Cost Reduction Strategies Burns and Associates, Inc www.costreductionstrategies.com(under construction) www.employeebenefitsstrategies.com(under construction)
jpod Posted July 9, 2013 Posted July 9, 2013 GBurns, I am not grasping your concern; perhaps it is more nuanced than I see. If the employee says "Yes, I wish to cover my spouse," hasn't he/she already told you he/she is married?
ForksnKnives Posted July 9, 2013 Posted July 9, 2013 Isn't it against the law to ask a job applicant their marital status? If this is so, then it seems that asking for the marriage certificate of an employee would also be unlawful. Signing an attestation might be okay. Different issues; different laws governing those situations. If an employee wishes to cover his or her spouse under an employer-sponsored health insurance plan then the employee has no choice but to disclose his or her marital status. http://kielichlawfirm.com
BG5150 Posted July 9, 2013 Posted July 9, 2013 If an employee wishes to cover his or her spouse under an employer-sponsored health insurance plan then the employee has no choice but to disclose his or her marital status. "I'm not gonna tell you if I'm married or not, but I really, really want to cover this lady who lives with me and shares my last name." QKA, QPA, CPC, ERPATwo wrongs don't make a right, but three rights make a left.
GBurns Posted July 11, 2013 Posted July 11, 2013 But disclosing does not mean providing documentary proof. George D. Burns Cost Reduction Strategies Burns and Associates, Inc www.costreductionstrategies.com(under construction) www.employeebenefitsstrategies.com(under construction)
Kevin C Posted July 11, 2013 Posted July 11, 2013 What about common law marriage? In Texas, if you agree to be married, live together as husband and wife and tell others you are married, you are married. Not having documentation doesn't necessarily mean they are not married.
John Feldt ERPA CPC QPA Posted July 11, 2013 Posted July 11, 2013 Some legal authority thus recognizes that as married, and there would be documentation to support that. If the local law only requires a verbal statement from an individual saying they married so someone else (although that's unlikely to actually be the extent of the law), then the plan administrator could certainly obtain this verbal statement to document that for their records.
masteff Posted July 11, 2013 Posted July 11, 2013 I was skipping the issue of common law unless someone else went there... For the sake of consistency, depending on the relevant state's law on common law marriage, I'd probably have a very basic form for them to both sign: "We, ___ and ___ are common law married in the state of ____". The benefit they're receiving is sufficiently valuable enough (or they wouldn't be trying to get said benefit) that they should be willing to put it in basic writing. If everyone else has to produce a document, why can't/wouldn't they sign one form? Kurt Vonnegut: 'To be is to do'-Socrates 'To do is to be'-Jean-Paul Sartre 'Do be do be do'-Frank Sinatra
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