Eligibility

Basic information about eligibility is provided below on covered members, eligible retirees, and eligible dependents. For information about coordination of benefits, overpayment/future offset, amendment or termination of benefits, HIPAA, extension of benefits to dependents, COBRA, coverage for dependent survivors, and third-party reimbursement/subrogation, consult our current Benefits Booklet. 

COVERED MEMBER

In order to be eligible for benefits through the FA Benefit Fund, you must be a covered member. Covered members include active, full-time Unit III employees of Suffolk County Community College covered by the collective bargaining agreement between the Faculty Association, Suffolk County Community College and the County of Suffolk, and active full-time employees of Suffolk County Community College covered by the collective bargaining agreement between the Guild of Administrative Officers, Suffolk County Community College and the County of Suffolk, and on whose behalf contributions are required to be made; officers and employees of the Faculty Association, the Guild, and the FA Benefit Fund on whose behalf the Faculty Association, the Guild and/or the FA Benefit Fund makes contributions; such retirees whom the Trustees may determine are eligible to participate in this Fund and who remit the required self-pay contribution; and other employees of the County of Suffolk in other bargaining units and non-bargaining units whom the Trustees may determine are eligible to participate in the FA Benefit Fund. 

You are entitled to benefits as long as you are in active payroll status or are an eligible retiree. Active payroll status means the period for which contributions are required to be made on your behalf. Covered members who are on unpaid leaves of absence remain eligible for benefits for so long as they are on approved leave, provided they make the required contribution to the FA Benefit Fund. (See section titled COBRA for further details.) In addition, adjunct faculty are eligible only for the Legal Services Program provided the College remits contributions to the Fund for the adjunct faculty.

Employees covered by the FA Benefit Fund will be eligible for benefits on the first day of employment. All benefits terminate at the end of the month in which the last contribution has been received by the FA Benefit Fund on the employee’s behalf.

ELIGIBLE RETIREES

Eligible members who retire may elect to continue coverage for the package of benefits offered by the FA Benefit Fund for retirees and their Continuation-eligible family members (dependents) for as long as the applicable self-pay contributions set by the FA Benefit Fund are paid. The retiree must also have maintained active membership in the Union, as defined by its Constitution, for the ten (10) years preceding retirement. At the time of retirement, the retiree must be an active member in good standing of the Union or if on approved leave, a member in good standing, and thereafter must maintain membership in the Union and pay the required union dues. 

ELIGIBLE DEPENDENTS

Your eligible dependents are covered for certain benefits as outlined in this booklet. Eligible dependents are dependents who are determined to be eligible by the FA Benefit Fund. A dependent can be eligible for EMHP coverage, but not necessarily eligible for the Fund (e.g., the Fund does not cover adult children up to age 26). You must enroll your eligible dependent with the Fund in order for them to be eligible for Fund benefits. 

Eligible dependents include:

• Your spouse
  
   
• Your domestic partner 

o    Who is eighteen years of age or older;

o    Who is not married or related by blood in a manner that would bar marriage in New York State;

o    Who has an exclusive mutual, close, and committed personal relationship with the covered member;

o    Who lives with the covered member and has been living with same on a continuous basis for six months and you are able to provide proof of residency and financial interdependence¹;

o    Has not terminated the partnership.

      

¹ Evidence of financial interdependence is not required if the covered member has received, and provides the Fund Office with a copy of, a certificate of domestic partnership issued by the Employee Benefits Unit for the Employee Medical Health Plan of Suffolk County (“EMHP”).

A person may be enrolled as a domestic partner if his or her partner is a Unit III or Unit IV employee of Suffolk Community College on the date of registration for whom the Employer makes contributions to the FA Benefit Fund or has retired as a Unit III or Unit IV employee of Suffolk Community College and is currently a covered member of the FA Benefit Fund. No person is eligible to be enrolled as a domestic partner who at the time of enrollment or at any time during the prior six months was enrolled as a member of another domestic partnership or was married to another individual and whose divorce decree was issued less than six months prior to submission of the application for enrollment.

Note on Tax Implications:  Under the Internal Revenue Service (IRS) rules, the fair market value of the health-related benefits is treated as income to the covered member/employee for tax purposes when a person who is not a qualified dependent under Federal IRS rules is covered under the FA Benefit Fund. Please ask your tax consultant how enrolling your domestic partner will affect your taxes.

If the partnership ends, the covered member must notify the Fund Office and end coverage for their domestic partner. There will be a one-year waiting period from the termination date of a previous partner’s coverage before the covered member may again enroll a domestic partner.

Covered members who fraudulently enroll a domestic partner are held financially and legally responsible for any benefits paid.

• Your unmarried dependent children who have not reached their 19th birthday (including legally adopted children) or stepchildren who reside with the covered member and for whom the covered member provides full financial support and who have not reached their 19th birthday. To establish eligibility of a covered member’s stepchild, the covered member must submit an affidavit verifying that the child resides full time with the covered member and proof of financial dependency as shown by income tax returns. This affidavit is available on this website and at the Fund Office: Student Verification Form.
  
  
  
  Other children who reside permanently with you in your household, who are chiefly dependent on you for support, are also eligible. To establish the eligibility of such a child, the covered member must submit an affidavit verifying that the child resides full time with the covered member and proof of both residency and financial dependence, as shown by income tax returns or a court order of guardianship for the child. The affidavit is available from the Fund Office.
  
   
• Unmarried dependent children who are full-time students at an accredited educational institution and have not reached their 25th birthday. An unmarried child who is a full-time student will be covered up to age 25 if he or she is enrolled for 12 undergraduate credit hours or 6 graduate credit hours per semester. A Student Verification Form (obtained from the Fund Office) must be completed and submitted to the FA Benefit Fund before a claim can be honored. This form must be filed each semester.

Part-Time Students Completing Graduation Requirements

Your unmarried dependent children who are over age nineteen (19) but under age twenty-five (25) who need less than a full-time course load to satisfy requirements for graduation may also be eligible. They must

o    Otherwise qualify as an eligible dependent of the enrollee;

o    Have been a full-time student in the term immediately preceding the semester or trimester in which course requirements will be completed; and

o    Provide the Fund Office with a statement from their school or college administrator which verifies the student’s status.

• Your unmarried children, regardless of age, who are incapable of self-sustaining employment by reason of mental or physical handicap and who become so prior to their attainment of age 19 and further provided that such children reside with a covered member and are wholly dependent on the covered member for support. You must submit proof of your dependent child’s incapacity to the Fund Office within 31 days after the date he or she attains the age at which his or her coverage would otherwise terminate, or within 31 days after you are notified of his or her ineligibility, 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.