Eligible Dependents
You may also enroll your Eligible Dependents in the health care plans. Please note that federal law (Medicare Secondary Payer Provisions in Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 (42.U.S.C 1395y(b)(7)&(b)(8)).) now requires the Company to have Social Security numbers on file for all individuals enrolled in a PG&E-sponsored medical plan.
Eligible Dependents include:
  • Your legally married spouse, legally state-recognized common-law spouse, or registered domestic partner;
"Mini-Med" Plans
If your child under age 26 has access to a "mini-med" plan offered by another employer, PG&E will allow you to enroll your eligible child as a dependent in your PG&E-sponsored health care coverage. Mini-med plans are medical plans that provide extremely limited coverage and have been granted an official waiver from the annual benefit caps on essential health benefits by the U.S. Department of Health and Human Services. Your adult child should receive an annual notice of this waiver from his or her employer or health insurance issuer. You should keep a copy with your records. You may be asked to submit a copy of this notice to PG&E to validate your child's eligibility for PG&E-sponsored coverage.
  • Your children who are under age 26, including stepchildren, children born during a registered domestic partnership, foster children, legally adopted children, and children for whom you have been permanently appointed legal guardianship by a court (does not include the legal wards of your spouse), who are not eligible for coverage under an employer-sponsored health plan (including employer-sponsored coverage through a spouse/domestic partner of their own), regardless of cost. Eligibility for coverage under another parent's group health plan or in a limited medical plan, commonly referred to as a "mini-med" plan, does not count for this purpose;
  • The children of your registered domestic partner who are under age 26, including legally adopted children (for employees and retirees only) who are not eligible for coverage under an employer-sponsored health plan. (Note that a child for whom your registered domestic partner is the legal guardian is not an eligible dependent). Eligibility for coverage under another parent's group health plan or in a limited medical plan commonly referred to as a "mini-med" plan does not count for this purpose;
  • Your disabled children or those of your spouse/registered domestic partner who are age 26 or older, who are certified as disabled by a Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.), and who have been approved by a PG&E-sponsored medical plan provider for continued coverage before they reach age 26. For more information, please contact the Member Services department of the medical plan in which you are enrolled (see "Disabled Dependents", under "Eligible Dependents" for more information); or
  • Your family member or registered domestic partner if you both are Management and Administrative & Technical employees; both are union-represented employees; or both are retirees. You each have the option of electing coverage as an "employee" or "retiree," or you can be covered as a "dependent" of the other. However, you may not be covered as both. In addition, you may not be covered as both an employee and a retiree.
Employee/Retiree Couples
If you and your family member or registered domestic partner are both union-represented employees or are retirees, you each have the option of being covered as an "employee" or "retiree," or you can be covered as a "dependent" of the other. However, you may not be covered as both. In addition, you may not be covered as both an employee and a retiree.
Qualified Medical Child Support Orders
Federal law requires employer-sponsored group health plans to recognize Qualified Medical Child Support Orders (QMCSOs) by providing benefits for eligible children of plan participants in accordance with the terms of the orders. A court order or a National Medical Support Notice issued by a State child support enforcement agency must identify the child who is the "alternate recipient" of health coverage, describe the type and duration of coverage, and cannot require a health plan to provide benefits which are not otherwise available under the plan. The Company will determine if a court order or a National Medical Support Notice satisfies the legal requirements to be a QMCSO in accordance with the written procedures established under the Plan. You may request a copy of the procedures, free of charge, by calling the PG&E Benefits Service Center at 866-271-8144 (open weekdays from 7:30 a.m. to 5 p.m. Pacific time).
  • You will be notified of the receipt of an order affecting your children and the Company's procedures and determination with respect to the order. If an order satisfies the legal requirements, coverage may be provided for your child until the earlier of:
  • The date the coverage stops as provided in the order;
  • Your termination of coverage as an employee (subject to your right to elect continuation of coverage); or
  • The date the child ceases to be an Eligible Dependent.
The Company will enroll the child pursuant to the court order and deduct any required contributions, even without the participant's direct consent. If you are not already enrolled, you must elect to participate at the time you are required to provide coverage for your child(ren); you may not enroll your child(ren) unless you also elect coverage for yourself. If you are enrolled in a health care program that will not cover dependent children who do not reside with you, you may change to a program for which you are eligible that will cover your children. If you do not voluntarily change, the Company will enroll you in the Network Access Plan (NAP) or the Comprehensive Access Plan (CAP), as appropriate for your home ZIP Code, and will deduct the required monthly contributions associated with NAP or CAP.
National Medical Support Notices
If a Participating Employer receives a court-ordered judgment or decree requiring you to cover an eligible dependent child, the child will be enrolled in your health care plans, pursuant to the court order or judgment. Coverage for the child will be effective the first of the month following enrollment by PG&E, and your health plan premium costs will be adjusted to reflect the coverage of the child, if applicable. If you are enrolled in a health maintenance organization (HMO) and your child does not live within your HMO's service area, you will be switched to the Network Access Plan (NAP) or the Comprehensive Access Plan (CAP), as applicable for your family's ZIP code, and you will be responsible for paying the required premium contributions associated with the NAP and CAP plans.
Registered Domestic Partners and Same-Sex Spouses
Registered domestic partners and same-sex spouses of employees are eligible for coverage under the Company's medical, dental and vision care plans. Both same-sex and opposite-sex registered domestic partners are eligible for coverage. In addition, because of limitations under federal law, same-sex spouses are treated as registered domestic partners.
To be eligible for domestic partner benefits, the domestic partnership must be registered with a government entity (e.g., the City and County of San Francisco), pursuant to state or local law authorizing such registration, or be a same-sex marriage performed by a government entity. For a partial list of municipalities that currently offer a domestic partner registry, you can access an online copy of "Your Guide to Domestic Partner/Same-Sex Spouse Benefits at Pacific Gas and Electric Company" under the "Domestic Partner Benefits Guide" link on the Benefit Plan Documents section of the PG&E@Work intranet, or you can request a copy by calling the PG&E Benefits Service Center at 866-271-8144 (open weekdays from 7:30 a.m. to 5 p.m. Pacific time).
If you wish to cover your registered domestic partner or same-sex spouse under any Company-sponsored benefit plans, you must contact the PG&E Benefits Service Center within 31 days of your marriage or domestic partnership registration date.
If you fail to do so, you must wait until the next Open Enrollment period to enroll your registered domestic partner or same-sex spouse. You may be required to provide proof of domestic partnership registration or a certificate of same-sex marriage to the Company upon request.
Tax Implications of Coverage for Your Same-Sex Spouse, Registered Domestic Partner, or Children of Your Same-Sex Spouse or Registered Domestic Partner
Federal Taxes
It is important to note that the value of the health care coverage provided for a registered domestic partner, same-sex spouse, or any enrolled dependent children of a registered domestic partner or same-sex spouse is treated as income to you for federal tax purposes. PG&E will report the value of the coverage as income on your Form W-2 and will withhold federal income and employment taxes. The amounts taxable to you can be substantial.
An exception to these income reporting and withholding rules applies if your same-sex spouse, registered domestic partner, or children of your same-sex spouse or registered domestic partner are your tax dependents under Internal Revenue Code section 152, as amended by Code section 105(b).
Note: Many registered domestic partners and same-sex spouses do not qualify as tax dependents. However, if your enrolled, registered domestic partner, same-sex spouse, or his or her enrolled children are your tax dependents and you complete a Certification of Tax Dependency form, the value of the health care benefits will not be reported as taxable income. You must complete a new certification each year. If you don't receive a Certification of Tax Dependency form for the upcoming tax year, please call the PG&E Benefits Service Center to request a form. Forms received after the last day of the year will not be processed until the first of the following month after receipt.
You are encouraged to consult a tax professional before claiming that your registered domestic partner or same-sex spouse and/or the children of your registered domestic partner or same-sex spouse qualify as your tax dependents.
California Taxes
For California income tax purposes, the value of the health care benefits provided for your same-sex spouse and/or your same-sex spouse's dependents are excluded from your taxable income.
For California income tax purposes, the value of the health care benefits provided to your registered domestic partner and/or your registered domestic partner's dependents may be excluded from your taxable income if your partnership is registered with California's Secretary of State and if certain other conditions are met. Please contact your tax advisor and the PG&E Benefits Service Center for more information.
If you reside in a state other than California that recognizes domestic partners, you must satisfy that state's registration requirements. Exemption of state income tax on the imputed income will be based on that state's tax code.
More Eligibility and Tax Information for Registered Domestic Partners
Employees can find out more about eligibility and general information regarding taxation for registered domestic partner benefits by accessing an online copy of "Your Guide to Domestic Partner/Same-Sex Spouse Benefits at Pacific Gas and Electric Company" under the "Domestic Partner Benefits Guide" link in the Benefit Plan Documents section of the PG&E@Work intranet, or you can request a copy by calling the PG&E Benefits Service Center at 866-271-8144 (open weekdays from 7:30 a.m. to 5 p.m. Pacific time). However, employees are encouraged to seek advice from a tax professional for any questions they may have.
Also see "Change-in-Status Events and Other Changes Involving a Registered Domestic Partnership or Same-Sex Marriage" under "Change-in-Status Events" in the What If… section.
Registered Domestic Partner Dependents
The State of California considers a child born or adopted during the course of a registered domestic partnership to be a natural-born child to both partners — regardless of who is the child's biological birth-parent — and, consequently, such a child will continue to be considered an eligible dependent for purposes of health plan coverage in the event the registered domestic partnership is terminated. However, should your registered domestic partnership legally come to an end, any child born to or adopted by your registered domestic partner prior to the establishment of your registered domestic partner union must be dropped from your PG&E-sponsored health plans within 31 days, unless you have adopted the child or you have legal guardianship of the child.
Disabled Dependents
You can arrange for coverage to continue past the customary age limits for an unmarried child who is incapable of self-support because of a physical or mental disability, as certified by a Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.), provided the child's disability began and was certified through the PG&E Disabled Dependent process before he or she became otherwise ineligible for coverage. Your child must depend chiefly on you for support in order to qualify for the continued coverage and must also meet the definition of an Eligible Dependent.
For eligible dependents who are disabled and currently enrolled in a PG&E-sponsored health plan, you must contact the medical plan vendor directly to process the required certification before your disabled dependent loses eligibility. Loss of eligibility typically occurs at age 26. If you do not complete the certification on time, your disabled dependent can no longer be enrolled in the plan, effective the first of the month in which he or she is no longer eligible.
You must apply for continued coverage under a PG&E-sponsored medical plan for a disabled dependent within 31 days of the date on which your child's coverage would ordinarily end. Written proof of your child's continuing dependency must be provided upon request, but not more frequently than once a year after the two-year period following the child's attainment of the limiting age.
For more information about whether or not a dependent is eligible for coverage, please contact your benefit plan vendor. Contact information for each benefit plan vendor is listed under the Rules, Regulations and Administrative Information and Contacts sections of this Handbook.