DEPENDENT ELIGIBILITY
Family members eligible for benefits are:
- Spouses
- Registered domestic partners
- Dependent children up to the age of 23 years old if a full-time student
- Legally adopted children
- Stepchildren
- Children for whom the member has legal guardianship
- Developmentally disabled or physically handicapped children determined to be disabled/handicapped prior to attaining the age of 19 years
- Adult children up to the end of the month they turn 23 years old (optical and dental and the end of the year they turn 23 years old for the prescription benefit provided they are enrolled in the annual "Optional Prescription Drug Rider"
Documentation is required for all dependents. Members must provide copies of Marriage Certificates, registration of Domestic partnership, birth Certificates, adoption papers, âaffidavit of Dependent stepchildrenâ, court ordered legal guardianship or medical documentation of disability.
Documentation may be faxed to the SOC Fund office at 212.406.3105, mailed to the
superior officers Council, 40 Peck Slip, New York, NY 10038, or downloaded at the SOC
website.
A domestic partner is defined as a âperson, eighteen years of age or older, who is not married or related by blood to the employee or retiree in a manner that would bar marriage in the State of New York, who has a close and committed personal relationship with the employee or retiree, who lives with the employee or retiree and has been living with them on a continuous basis, and who, together with the employee or retiree, has registered with the City Clerk as a domestic partner of the employee or retiree and has not terminated the domestic partnership.â Employees can obtain details concerning eligibility, enrollment, and tax consequences from their payroll or personnel office or from the Office of Labor Relations, Domestic Partnership Liaison Unit at 212.306.7605.
Dependent Children
Eligible dependent children include natural children, legally adopted children, stepchildren, children for whom you have court appointed guardianship or legal custody and who are unmarried and live with you permanently. For the purpose of the Dental and optical benefit, eligible dependent children are covered until the end of the month day in which they reach their 23rd birthday.
For the prescription benefit, dependent children are covered until December 31st of the year they reach the age of 23 years old. Coverage may be extended for adult children up to age 26 who meet the specific criteria outlined below in the âRequest for Coverage of Adult Children Up to Age 26.â
Stepchildren
Effective January 1, 2011, the Fund will provide benefit coverage for membersâ stepchildren. To enroll your stepchildren, you must complete the âaffidavit of Dependent stepchildrenâ and submit to the SOC Fund Office. Coverage will only be extended to Stepchildren who meet the specific criteria outlined in the âaffidavit of Dependent stepchildren,â which can be downloaded at www.nypdsoc.com.
Dependent coverage is also extended to any unmarried child, regardless of age, who: is
in-capable of self-sustaining employment by reason of a mental or physical handicap, who
becomes so prior to attainment of age 19, and who resides with and is wholly dependent
on the covered member for financial support. You must submit proof of your dependent
childâs incapacity to the SOC Fund Office within 31 days after the date he/or she attains the age at which the coverage would otherwise terminate, or within 31 days after you are notified of their termination of eligibility, whichever is later. Proof of the continued
existence of such incapacity shall be furnished to the SOC Fund Office from time to time
at its request.
Student Proof
Effective September 1, 2021 student proof is no longer required for dependents over the age of 19 years old. See definition of Dependent Children above.
To add a spouse, domestic partner, or child, the member may drop off, mail or fax to
212.406.3105 the appropriate required documentation.
If participants become ineligible for benefits under the Plan for any reason, and then subsequently become reinstated and eligible for benefits at a later date, the participants will continue to receive these benefits at the same level they were receiving them as of the day the
participants became ineligible.
It is important that you immediately notify the SOC Fund Office of any change in your social/family status (adding dependents due to marriage, domestic partnership, birth, or adoption of a child, or dropping dependents due to death, divorce, legal separation, termination of domestic partnership or a child becoming ineligible due to age.
If it is found that a participant or beneficiary fails to submit requested information regarding dependents, fails to notify the SOC Fund Office immediately following a change in the participantâs or beneficiaryâs social/family status, change in student status, makes a false statement, or furnishes fraudulent or incorrect information, the authorized representatives of the SOC Fund Office, Trustees, or any of their designees in their sole and absolute discretion reserve the full authority to deny, suspend or discontinue the participant or beneficiaryâs benefits provided under the Plan at any time and for any length of time. Furthermore, a failure to notify the SOC Fund Office of a change in social/family status will leave the participant or beneficiary personally responsible for all expenses/costs incurred by
the Fund, retroactive to the effective date of the assigned coverage whereby the dependent
was ineligible for benefit coverage under the Plan, as a result of administering benefits to
members and dependents in this fraudulent situation.
Any participant or beneficiary who willfully and knowingly engages in an activity intended to
defraud the Plan will face loss of coverage under the Plan, will be held personally liable to the
Fund for all costs/expenses incurred by the Fund, and will be subject to all other legal remedies available to the Fund at that time.
In order to protect you and your familyâs rights, it is imperative that all participants and beneficiaries keep the SOC Fund Office up to date of their current family/social status, address, telephone number, and e-mail address. You can update changes through the SOC website at www.nypdsoc.com.