Domestic Partner Benefits

Domestic partners qualify for enrollment in the ACC group health insurance plan and can only be added during Open Enrollment. They do not qualify for dental, vision, dependent life insurance, or COBRA benefits.

Domestic partnership has been defined as two people, of the opposite or same gender, who live together in the mutual interdependence of a single home and have signed a Declaration of Domestic Partnership form. Domestic Partners must meet all the requirements on the Declaration of Domestic Partnership form, and complete and file form with the ACC Municipal Court. Continued eligibility of your Domestic Partner depends upon the continuing accuracy of this form. Domestic Partner eligibility ends on the date a Domestic Partner no longer meets all the requirements listed on the form. Termination of domestic partnership must be filed through the court.

The requirements include but are not limited to:
  1. Partners have shared a primary residence for the previous 6 months
  2. Partners have a committed, interdependent relationship intended to be lifelong
  3. Partners are jointly sharing the household obligations and necessities of life
  4. Neither partner is currently married or legally separated from anyone
  5. Both partners must be at least 18 years old
  6. Both partners must be of sound mind
  7. Partners are not blood relatives
  8. Partners are the sole domestic partner to one another
  9. Neither partner is recently, legally separated from another domestic partnership by less than 6 months
    1. To terminate a domestic partnership you must file a termination with the court at least 6 months prior to establishing a new domestic partnership, with the exception of termination due to the death of a Domestic Partner.
To Declare a Domestic Partnership

STEP 1: Go to the ACC Municipal Court and file a Declaration of Domestic Partnership. There will be a filing fee. Keep a copy for your records and bring an original to the Human Resources Department.

Complete an Affidavit of Financial Reliance form and a Dependency Tax Questionnaire form and submit to from Human Resources. Both parties must sign in front of a notary before he/she will notarize the form. There are notaries in HR who can notarize these documents. If you are registering your Domestic Partner as an income tax dependent, you will also be required to complete a Pretax Domestic Partner Benefits Statement of Understanding form and submit proof of tax dependency. Please contact Human Resources for additional details.

STEP 3: To add a domestic partner or change your health insurance election, you must provide HR with a Declaration of Domestic Partnership form from the Municipal Court, a notarized Affidavit of Financial Reliance form, a notarized Dependency Tax Questionnaire form, your domestic partner’s social security number and his/her birth date.

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