Benefits Eligibility


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Employee Eligibility

Employees eligible for benefits are regular faculty or staff and non-regular term appointment faculty or staff working 30 hours or more per week.

 

Dependent Eligibility

Eligible dependents (of eligible employees) for medical/prescription/dental/vision plans are defined as:

  • Legal spouse, unless legally separated, but only if not covered as an employee or dependent under the plan.
  • Qualified domestic partner (please see NMSU policy manual for more information)
  • familyChild(ren) less than 26 years of age:
    • Biological children
    • Step-children, or children for whom you have court-appointed guardianship
    • Children for whom you have a Qualified Medical Child Support Order or other Court Appointed Guardianship
    • Legally adopted children
    • Biological or adopted children of a qualified domestic partner
    • All children defined above who are: 1) age 26 and older 2) permanently disabled and not able to earn his or her own living because of a physical or mental disability which started prior to reaching age 26. The disability must be supported by physician certification.

Eligibility for dependent children on life insurance policies vary by policy; please refer to the plan information for each life policy to verify dependent eligibility.

 

Register Dependents for Enrollment

In order to enroll dependents in benefits, they must be put on file with Benefit Services. To do this, employees adding dependents must provide proof of eligibility for each dependent to be covered. Here is a list of acceptable documents for each dependent type that must be attached to your benefits enrollment form.

Spouse

Requirement: Must be your legal spouse, unless legally separated
Proof of Eligibility: Copy of presently valid legal or religious marriage certificate, which must include the date of marriage.

Domestic Partner

Requirement: Two individuals who live together in a long-term relationship of indefinite duration. There must be an exclusive mutual commitment similar to that of marriage, in which the partners agree to be financially responsible for each other’s welfare and share financial obligations.
Proof of Eligibility: See our Domestic Partner’s benefits page for the Affidavit and acceptable supporting documentation.

Child under age 26

Requirement: Must be your qualifying child(ren) until they reach age 26.
Proof of Eligibility (must support the parental relationship). Submit 1 of the following:

  • Copy of the child’s legal or state issued birth certificate naming you, your spouse or your domestic partner as the child’s parent.
  • Copy of a final court order (divorce decree/custody agreement) naming you, your spouse or your domestic partner as the child’s parent. All documents must include the following information: names of the child and parent, official signature and/or court seal/stamp.
  • Copy of legal adoption papers issued by the courts naming you, your spouse or your domestic partner as the adoptive parent. All documents must include the following information: names of the child and parent, official signature and/or court seal/stamp.
  • Copy of legal guardianship/custody papers issued by the courts naming you, your spouse or your domestic partner as the child’s guardian. All documents must include the following information: names of the child and guardian, official signature and/or court seal/stamp.
  • Copy of a Qualified Medical Child Support Order (QMCSO) showing you are required to provide medical coverage for the child. Documentation must state your current employer’s name and include the names of the child and parent.
  • NEWBORNS ONLY (within 31 days of date of birth): Copy of official hospital proof of birth form with the mother’s name and the baby’s name. If the birth mother is not covered on the NMSU benefits, then proof of marriage or domestic partnership will need to be provided to establish the mother’s relationship to the employee. A copy of the child’s birth certificate must also be provided, upon receipt, within 3 months of the child’s birth to continue coverage

If you are an employee providing documentation for a child of your legal spouse or domestic partner, documentation must also include the required documentation listed for Spouse or Domestic Partner.

Child age 26 and older

Requirement: Any dependent disabled child, over the age of 26 who otherwise meets the criteria for “child” and is permanently disabled and not able to earn his or her own living because of a physical or mental disability which started prior to the date he or she reaches the maximum age for dependent children under the Plan.
Proof of Eligibility: Documentation must support the dependent relationship and disabled status. Submit the following set of documents:

  • Any one of the documents listed for Child to age 26; AND the following document:
  • Physician statement certifying that the dependent child cannot support themselves because of a physical or mental disability prior to reaching the maximum age. All information must be pre-printed and dated within the last 12 months.

Specifically for medical/dental plans through New Mexico Risk Management Division: Physician must complete the medical carrier’s Disabled Dependent Request Form certifying that the dependent child cannot support themselves because of a physical or mental disability prior to reaching the maximum age. The carrier will then determine eligibility for benefits and either approve or decline the coverage. The Disabled Dependent Request Form must be completed by the physician and submitted to the medical carrier each year for approval to continue the coverage. The forms for each carrier can be found at www.mybenefitsnm.com under Forms, Guidelines and Policies: Disabled Dependent Forms.

Note: Additional information or carrier specific form may be required by the benefit carrier to determine eligibility for benefits.

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