The office of General Counsel issued the following informal opinion on August 24, 2001, representing the position of the New York State Insurance Department.Re: Health Insurance Coverage, Domestic Partners
Are domestic partners of employees eligible to be covered as dependents on group medical, dental or vision care contracts?
The New York Insurance Law permits, but does not require, insurers to offer domestic partner coverage.
None presented. This is a general inquiry.
Policies and contracts covering medical, dental or vision care are subject to the same requirements concerning eligibility of groups for coverage. New York Insurance Law §4235(f)(1) (McKinney 2001), which regulates group accident & health insurance policies issued by commercial insurers, provides with respect to such policies:
Any policy of group accident, group health or group accident and health insurance may include provisions for the payment by the insurer of benefits for the employee his spouse, his child or children, or other persons chiefly dependent upon him for support and maintenance .
New York Insurance Law §4305(c)(1) (McKinney 2001), which regulates group contracts issued by not-for-profit health insurers has a similar provision. Pursuant to New York Public Health Law §4406 (McKinney 2001), New York Insurance Law §4305(c)(1) is also applicable to group contracts issued by Health Maintenance Organizations.
The New York Insurance Law does not prohibit coverage of domestic partners, provided there is a showing of economic, as opposed to emotional, dependence. Such dependence would include both unilateral dependence and mutual interdependence. Mutual interdependence may be evidenced by a nexus of factors, such as common ownership of property, common householding, shared budgets or length of relationship. The registration of a domestic partnership, such as is authorized in New York City, New York City Ad. Code §3-240 et seq. (2001), would constitute strong evidence of mutual interdependence.
Accordingly, with respect to group policies and contracts, should the employer opt to request the coverage, the insurer may, at its option but need not, include coverage of domestic partners.
For further information you may contact Principal Attorney Alan Rachlin at the New York City Office.