skip navigation

Florida Gulf Coast University

Website Directory  

Human Resources

Follow us on Twitter Join us on Facebook Reconnect on LinkedIn
Human Resources
Benefits
Employment
Payroll
Organization Development
HR Staff & Services
Related Resources

Human Resources Department
Florida Gulf Coast University
Modular 2
10501 FGCU Blvd. South
Fort Myers, FL 33965-6565

Tele: (239) 590-1400
Fax: (239) 590-1011
Email: hresources@fgcu.edu

If you have a hearing or speech impairment, call Florida Gulf Coast University using the Florida Relay at 711.

Domestic Partner Benefit

 
 

Domestic Partner Health Insurance Stipend (DPHIS)

Who is Eligible?

 Domestic Partner is defined as a same-sex individual who shares a committed, mutually-dependent relationship with a full-time SP/Faculty/A&P/Executive Services employee who is enrolled in one of our health insurance plans.

  • Must be 18 years of age and mentally competent to contest to a contract
  • Not legally married to anyone else and are not related
  • Have shared financial responsibilities for at least the past 6 months
  • The non-employee domestic partner is not employed or is not eligible for health benefits through his or her employer
  • Health insurance is in effect for the domestic partner and coverage shall be maintained during any period for which the domestic partner health insurance stipend is paid

What is the Enrollment Process?

  • The amount of the stipend will be the lesser of: (1) $500 a month; or (2) the actual cost of the domestic partner’s own non-employer provided insurance coverage.
  • The employee must submit the completed DPHIS Program Declaration and Partnership Certification form
  • The employee must also submit at this time required documentation as proof of eligibility
    • Documentation from the employee’s domestic partner, such as employer-provided handbook, benefits booklet or other documents showing the domestic partner, if employed, is not eligible for health insurance.
    • Proof of health insurance coverage and the cost of the premium for the domestic partner.
    • Documentation of at least three (3) of the following must be submitted to support the domestic partner relationship
  1. Joint ownership of real property
  2. Joint lease
  3. Joint ownership of personal property or assets, such as automobiles or stock
  4. Joint bank account
  5. Joint consumer or bank loan
  6. Joint credit cards
  7. Driver’s license or tax documents showing the same address
  8. Legal documentation demonstrating joint adoption or legal guardianship of any dependents, whether children or adults
  9. Designation of health care surrogate
  10. Mutual designation as attorney in a durable power of attorney document
  11. Designation of beneficiary for life insurance, retirement plan, and/or last will and testament
  •  If the completed form and required documentation are received in HR prior to the 15th of the month, payment of the stipend to the employee will be made on the first pay date of the following month.

 How often is participation reviewed?

The employee must submit documentation of the domestic partner’s health insurance coverage and premium payment to HR on a semi-annual basis by September 15th and March 15th of each year. FGCU may terminate the health insurance stipend if the employee does not provide proof of continued health insurance coverage for the domestic partner.

What is the re-certification process?

To continue in the program, the employee must annually complete and submit the DPHIS Program Declaration and Partnership Certification form by March 15th. If the form is not completed and returned to Human Resources by March 15th, the stipend will be canceled and not continued until proper documentation is submitted. Payment of the stipend will not be retroactive for any time period due to lack of documentation.

How long is the Employee eligible for the stipend?

An employee receiving the domestic partner health insurance stipend must notify Human Resources immediately, but no later than 15 days, via completion and submission of the Termination of Domestic Partnership Health Insurance Stipend form, after any of the following actions occur:

  • If the domestic partner becomes eligible for insurance coverage through his or her employer
  • Termination of the domestic partnership for which participation in the program has been approved
  • Death of the domestic partner

The employee must wait six (6) months from the date of termination of a domestic partnership before applying for another domestic partnership health insurance stipend. However, if they are applying for the same domestic partner again, they must only wait three (3) months from the date of the prior termination of the stipend. The employee must complete a new DPHIS Program Declaration and Partnership Certification form.

Forms:

DPHIS Certification

DPHIS Termination

To review the Domestic Partner Health Insurance Stipend Program Description, click here.