Definition of Other Eligible Person (OEP)
Under this program a non-represented WSU employee, or upon agreement by the applicable union, a represented employee, who does not already enroll a spouse for medical, dental and/or tuition benefits may enroll one other eligible person (“OEP”), if ALL of the following eligibility criteria are met:
- The OEP is an adult, age 26 or older;
- The OEP currently resides in the same residence as the employee and has done so for the 18 continuous months prior to the individual’s enrollment, other than as a tenant;
- The OEP is not a “dependent” of the employee as defined by the IRS; and
- The OEP is not related by blood or by marriage.
Children who are qualified as WSU-defined dependents by an employee’s OEP are also eligible for benefits.
Eligibility to continue coverage for the OEP ceases at the end of the month in which the above criteria are not met. Employees must immediately notify Wayne State University’s Department of Total Compensation and Wellness of a change in eligibility status. Upon termination of coverage due to ineligibility as the OEP, COBRA continuation coverage for the individual will not be available.
Benefits Available to Other Eligible Persons
Cost of Other Eligible Person Benefits
The medical insurance rates for Other Eligible Persons are identical to the rates for spouses, i.e., the employee would pay the two-person medical insurance rate if the coverage changes from single to two-person. There is no cost to employees or Other Eligible Persons for dental insurance. The tuition benefit covers 50% of the tuition costs after any grants or scholarships are applied for all classes except those offered through the Law, Pharmacy or Medical schools. The benefit does not include the registration fee, the omnibus fee or other incidental fees.
Taxation of Other Eligible Person Benefits
The employer cost of providing benefits of the type described above for Other Eligible Persons is considered ordinary income and is, therefore, subject to taxes, including FICA, FICA Medicare, federal, state and city taxes. As a result, the cost to the employee of obtaining benefits for an Other Eligible Person is actually more than just the cost of the medical premium. Even though there is no employee cost for dental insurance, the value of this benefit is also taxable when a Other Eligible Person is added. And, if an Other Eligible Person is added to an already established family medical and/or dental policy, the employee will be taxed on the cost of providing single coverage, even though there will be no change in the actual cost of the insurance for the employee. In addition, the portion of the employee contribution associated with the Other Eligible Person healthcare coverage must be deducted on a post-tax basis.
Click the following for more information on taxation of these benefits: /hr/tcw/other-benefits/oep-taxing-benefits.pdf
The university is of the opinion that records containing information on Other Eligible Persons are confidential, but the law is uncertain in this area. It is possible that a court or other adjudicative agency would decide the university must make such records public. Therefore, it is important to understand there is risk of disclosure when signing up for Other Eligible Person benefits at a public university.
There are no rights to COBRA continuation for a Other Eligible Person.
Medical/Dental: To add your Other Eligible Person to your Medical and/or Dental insurance you must:
- Complete the Medical Plan Enrollment Form to enroll your Other Eligible Person in a health plan.
- Complete the Dental Enrollment form.
Return the completed enrollment form with copies of the documents which satisfy the requirement for proof of eligibility.
Reduced Tuition: To obtain reduced tuition benefits for your Other Eligible Person each semester you must:
- Complete the Reduced Tuition Benefit Application for Spouse/Children. Where applicable cross off "Spouse" and write in "Other Eligible Person".
- All forms may be obtained online or from the Total Compensation and Wellness department.
Failure to notify WSU of a change in circumstances is cause for disciplinary action against the employee and liability for losses incurred.