Domestic Partner Affidavit With Ad And D

State:
Multi-State
Control #:
US-02268BG
Format:
Word; 
Rich Text
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Description

Affidavit of Domestic Partnership for Employer in Order to Receive Benefits
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How to fill out Affidavit Of Domestic Partnership For Employer In Order To Receive Benefits?

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FAQ

One simple way to do the calculation is to determine the difference between your company's cost of an employee-only monthly premium and the cost of an employee-plus-one monthly premium. Multiply that number by 12 and you will get your total.

Federal law treats benefits for spouses, children and certain dependents the same way. However, a domestic partner is not considered a spouse under federal law.

This plan covers your spouse or domestic partner for 60% of your coverage amount. If eligible children are covered, then your spouse or domestic partner is covered for 50% of your amount and each child for 20%.

The imputed income reflecting the additional employee and LANL-subsidized (employer) medical costs will show on your payslip as Imputed Inc DP. Your federal and state tax withholding will be increased to reflect this higher income and will therefore impact your paycheck.

Imputed income is defined as the value of the domestic partner coverage minus the after-tax amount contributed toward the coverage.

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Domestic Partner Affidavit With Ad And D