Page 5 - Watkins Associated Industries, Inc - 2022 Benefits Guide

ELIGIBILITY (CONTINUED)

Domestic Partners/Common Law ii. joint checking account;
Watkins Associated Industries, Inc. acknowledges the needs of a iii. joint credit account;
diverse workforce and fairness in providing benefits to our employees, iv. joint ownership of motor vehicle;
their dependents, and their spouses and domestic partners. Therefore, v. designation of domestic partner as primary beneficiary in will;
domestic partners will receive the same benefits that are available to
spouses of Watkins employees. vi. designation of domestic partner as primary beneficiary of life
insurance policy or retirement plan funds; vii. durable property or
Domestic partners are those individuals who meet the following criteria: health care power of attorney
• At least 18 years old and mentally competent to consent to a legally Procedure
binding contract.
Employees who wish to apply for domestic partner benefits must
• Not legally married to anyone.
complete a Domestic Partner Affidavit and/or complete a Certificate of
• Not related by blood to a degree of closeness which would prohibit Domestic Partner Qualification for those dependents that are qualified
legal marriage in the state in which you legal reside. tax dependents. The form can be located in the “Resources Page” of the
• Have entered into the domestic partner relationship voluntarily and Benefits Center at www.watkinsbenefits.com.
without reservation for at least twelve consecutive (12) months at the
time benefits coverage is effective. This original form will be kept on the employee record within the Benefit
Center and will be deemed effective until one of the following occurs:
• Are jointly responsible for each other's common welfare and share
financial obligations. • The employee may request a partner designation change or removal
by completing either a Certificate or Statement of Termination.
• Share the same primary residence and intend to do so indefinitely.
Benefit coverage for the domestic partner and his or her dependents
• Intend to continue the domestic partner relationship indefinitely, will terminate on the date in which the relationship ended.
with the understanding that the relationship can be terminated at
any time by either partner.
• Can provide government issued domestic partnership certificate.
• If you do not have a government issued certificate, we can in lieu of the
certificate demonstrate our joint responsibility for each other’s common
welfare and financial obligations by providing proof of the existence, for a
minimum of twelve consecutive (12) months before benefits coverage is
effective, of at least one (1) or three (3) of the following:
i. joint mortgage or lease or other written evidence of common
residence, such as joint utility bills;

WELLBEING
WELCOME BENEFIT BASICS MEDICAL DENTAL VISION HSA FSA DISABILITY/LIFE ADDITIONAL BENEFITS 401(k) CONTACTS 5
PROGRAM