Northern Arizona University

Step One – Determine if a domestic partner is eligible for coverage:

• share residence with the employee and have done so continuously for the past 12 months;
• not be legally married to or separated from anyone else;
• not be a close blood relative;
• be at least 18 years old; and
• meet certain tests demonstrating financial interdependency.

For a complete list of criteria, use the Qualified Domestic Partner Affidavit form. 

Step Two – Determine if a qualified domestic partner’s child qualifies:

• the natural child, adopted child, or stepchild of the domestic partner,
• unmarried,
• under the age of 19 or under the age of 25 and a full time student,
• any age and disabled (if disabled prior to age 19), or
• under the age of 19 and is a foster child or has the domestic partner as a court-ordered guardian.

Step Three – Determine if a qualified domestic partner’s child fulfills the requirement to be a tax dependent:

Your domestic partner’s child does not need to qualify as a tax dependent to qualify for insurance coverage, however, if your domestic partner’s child does not qualify as a tax dependent, you may be taxed on any additional employer's contribution toward coverage. (See Tax Information for further details.)

This could mean that the additional employer’s contribution is

• added to your taxable gross income,
• reflected on your W-2, and
• taxed each pay period.

To make this determination, use the Domestic Partner’s Child Declaration of Tax Status form. If you are unsure whether your domestic partner’s child meets the support requirement for dependent status, you may confirm eligibility by using the optional Worksheet for Determining Support form. This worksheet is for your records only.

Since tax rules are complex, we recommend you consult with a tax advisor to be sure you are clear on the tax implications for your individual situation.

Step Four – Enrolling the child of your qualified domestic partner:

To enroll yourself and all dependents, complete the following forms:

• Checklist for Enrollment
• NAU Domestic Partner's Enrollment Form
• Domestic Partner’s Child Declaration of Tax Status (must complete one for each child)
• Qualified Domestic Partner Affidavit (notarized and with supporting documentation)
• Qualified Domestic Partner Declaration of Tax Status

Submit all forms and documentation to NAU Human Resources, Attn: Benefits, Box 4113, Flagstaff, AZ 86011