Glossary
Adoption Decree – This is the legal document filed upon finalization of an adoption that makes the child the legal child of the adopted parents. The decree may also set forth a new name. An adoption decree can be used in place of a birth certificate to establish a parent-child relationship for an adopted child and validate a child’s dependent status.
Affidavit – A formal sworn statement of fact, signed by the affiant or deponent (the person who is offering the sworn statement) whose signature is witnessed by a notary public.
Amnesty – Is an act by which an entity (such as an employer) restores those who may have been guilty of an offense against it (such as a plan participant) to compliance status.
Birth Certificate – Requiring a birth certificate which lists parent names establishes the relationship of a child to the plan participant or the plan participant’s spouse or domestic partner. While some states issue a birth record or “short form” document for identity purposes, each state also offers the full certificate including parent names. The birth certificate will validate a child, dependent of eligible dependent (such as a grandchild) or a stepchild.
Certificate of Disability – This is a document that is used by the IRS to validate whether a person is physically or mentally disabled. For the Dependent Audit process this document could be used to validate a disabled dependent’s eligibility.
Child Support Order – A Child Support Order is a document from a court that states (a) when, (b) how often, and (c) how much a parent is to pay for child support. This document provides the details of financial support and/or health benefits coverage for a child of the noncustodial parent and may be used to validate a child or stepchild’s relationship to the biological parent.
Consolidated Omnibus Reconciliation Act (COBRA) – A health insurance plan which allows a plan participant who leaves a company to continue to be covered under the company’s health plan, for a certain time period and under certain conditions. The system is designed to prevent plan participants who are between jobs from experiencing a lapse in coverage.
Common Law Marriage – In a handful of states (Alabama, Colorado, District of Columbia, Georgia, Idaho, Iowa, Kansas, Montana, New Hampshire, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina and Texas), opposite sex couples can become legally married without a license or ceremony. Contrary to popular belief, a common law marriage is not created when two people simply live together for a certain number of years. In order to have a valid common law marriage, the couple must do all of the following:
- live together for a significant period of time (not defined in any state)
- hold themselves out as a married couple — typically this means using the same last name, referring to the other as “my husband” or “my wife,” and filing a joint tax return, and
- intend to be married
When a common law marriage exists, the spouses receive the same legal treatment given to formally married couples, including the requirement that they go through a legal divorce to end the marriage.
Dependent – A person who depends on another as a primary source of income. For purposes of the DE Audit, this person would be enrolled on an employee benefit plan.
Divorce Decree – This is a court document detailing a divorce. A divorce decree listing relevant parties can be used to establish a parent-child relationship, as well as a court directive to provide health insurance. This document can be used to validate a child, stepchild and/or former spouse.
Documentation Establishing Common Residency – A driver’s license, school record, household account, or state identification card can be used to establish that the plan participant and his or her dependents live with them. These documents validate a spouse, domestic partner or a common law marriage.
Documentation Establishing Financial Interdependence – Proof of financial interdependence is used to establish that a marriage continues to exist. A jointly filed federal tax return, joint mortgage/lease, or joint bank or credit account will prove financial interdependence. These documents may validate a spouse, domestic partner or common law marriage.
Domestic Partner – A domestic partnership is a legal or personal relationship between two individuals who live together and share a common domestic life but are neither joined by marriage nor a civil union.
Employee Retirement Income Security Act (ERISA) – The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that mandates minimum standards for most voluntarily established pension and health plans in private industry to provide protection for individuals in these plans. ERISA requires plans to provide participants with plan information including important information about plan features and funding; provides fiduciary responsibilities for those who manage and control plan assets; requires plans to establish a grievance and appeals process for participants to get benefits from their plans; and gives participants the right to sue for benefits and breaches of fiduciary duty. In general, ERISA does not cover group health plans established or maintained by governmental entities, churches for their plan participants, or plans which are maintained solely to comply with applicable workers compensation, unemployment, or disability laws. ERISA also does not cover plans maintained outside the United States primarily for the benefit of nonresident aliens or unfunded excess benefit plans.
Federal Tax Return – A copy of the most recently filed federal tax return can be used to prove financial interdependence for a plan participant and spouse, domestic partner or common law marriage arrangement. In the instance of a disabled dependent over the limiting age of the Plan, the return is used to establish dependency upon the employee.
Health Insurance Portability and Accountability Act (HIPAA) – The Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of personal health information needed for patient care and other important purposes.
Legal Guardianship Order – A court order which establishes guardianship of a child. This documentation could validate the relationship of a child, stepchild, grandchild, foster child or a disabled dependent with whom they rely on for primary source of income.
Marriage Certificate – A marriage certificate can be used to establish that a marriage occurred. Sometimes a company may require a copy of the certified marriage certificate. This documentation can be used to validate a spouse and/or stepchild.
Personal Health Information (PHI) – Any information dealing with your own health.
Qualified Domestic Relations Order (QDRO) – A court order that uses pension or retirement benefits to provide alimony or child support, or to divide marital property, at divorce. This special order is necessary to comply with federal law governing retirement pay. A QDRO can be used to validate a child, stepchild and/or spouse.
Qualified Medical Child Support Order (QMCSO) – A court order that provides health benefit coverage for the child of the noncustodial parent under that parent’s group health plan. A QMSCO can be used to validate a child or stepchild.
Sarbanes-Oxley (SOX) – The Sarbanes-Oxley Act of 2002, also known as the Public Company Accounting Reform and Investor Protection Act of 2002 and commonly called Sarbanes-Oxley or SOX, is a United States federal law enacted as a reaction to a number of major corporate and accounting scandals. These scandals, which cost investors billions of dollars when the share prices of affected companies collapsed, shook public confidence in the nation’s securities markets. The legislation set new and improved standards for all U.S. public company boards, management and public accounting firms. It does not apply to privately held companies. The act requires the Securities and Exchange Commission (SEC) to implement rulings on requirements to comply with the new law.
Summary Plan Description (SPD) – A document containing a comprehensive description of a insurance plan, including the terms and conditions of participation.
