Full-time and part-time employees scheduled to work at least 20 hours per week and Residents are eligible for coverage.

Employee Eligibility

For benefit plan purposes, a benefit eligible employee is defined as a full-time employee working 30-40 hours per week or a part-time employee working 20-29 hours per week.


Residents are not eligible for Long-Term Disability or Retirement (ASRS, PTO and EIB).

Eligibility by Employee Classification
Benefit Full-TimeFull-Time (40-30 hours) Part-Time (29-20 hours)Residents
Medical PlansYesYesYes
Dental PlansYesYesYes
Vision PlanYesYesYes
Flexible Spending AccountsYesYesYes
Basic Life/AD&DYesYesYes
Optional Life/AD&DYesYesYes
Voluntary Short-Term DisabilityYesYesRefer to Contract or Academic Affairs
Accident InsuranceYesYesYes
Critical Illness InsuranceYesYesYes
Employee Assistance ProgramYesYesYes
Long-Term DisabilityYesYesNot Eligible
Retirement – ASRSYesYesNot Eligible
Deferred Compensation - 457(b)YesYesYes
Supplemental Retirement - 401(a)Yes, age restriction of 40 and older. Irrevocable election.
Vitality Wellness ProgramYesYesYes
PTO and EIBYesYesNo
Valleywise Health Employee AdvantageYesYesYes

Affordable Care Act

Since January 1, 2015, the Affordable Care Act (ACA) has required companies with more than 50 employees to offer medical coverage to all employees who work an average of 30 hours per week for a period of 12 months regardless of employment status. This is called the “employer mandate,” and it affects Valleywise Health.

Human Resources monitors employee hours for eligibility under the mandate. Employees meeting eligibility are notified by Human Resources of their eligibility and the 30-day enrollment period for employee and eligible child(ren). A spouse is not eligible for coverage under this federal law. Employee’s coverage is in effect for 12 months regardless of a reduction in hours or change in status.

Spouse or Domestic Partner

Legal spouse or same or opposite sex domestic partner.

Child(ren) under 26

Benefits terminate on the last day of the month of the child’s 26th birthday.

Disabled Child(ren)

Any child age 26 and older who resides with you, was medically certified as disabled prior to his/her 26th birthday and is dependent upon your support.

Dependent Verification

Valleywise Health requires appropriate documentation to prove dependent relationships prior to the close of any enrollment period. This includes documentation such as a marriage license, birth certificate or divorce decree. All required documentation must be received by HR prior to the end of your 30-day enrollment period.

Dependent Verification Documentation Requirements
• Send only copies. Documentation submitted will not be returned.
• If a document is two-sided or multiple pages, ensure you copy both sides and all pages of the document.
• If a document is not in English, you may be requested to supply an official English translation of the document and a copy of the original document.
Eligibility Requirements Acceptable Supporting Documentation
Submit two documents – submit one document from Proof A and one document from Proof B
Spouse Proof A Proof B
Legal Spouse • Valid legal or religious marriage certificate, which must include: Documents must be dated in the last 12 months and show name of employee and spouse as joint owners:
• Name of the employee and spouse • Utility bill
• Date of marriage • Federal or state income tax return indicating married
• Certifier’s signature/official seal • Document from bank account or financial institution
• Legal household/family registry, must show spousal relationship (This is only acceptable if you were married outside the U.S. and do not have a marriage certificate.) • Insurance document such as homeowner, renter, or automobile
(Employees married within the last 12 months do not need to provide Proof B.) • Mortgage document or current lease
  • Valid vehicle registration
Eligibility Requirements Acceptable Supporting Documentation
Submit two documents from Proof C, Affidavit and Tax Status Declaration
Domestic Partner Same or opposite sex domestic partner Proof C
Documents must be dated in the last 12 months and show name of employee and domestic partner as joint owners: • Your Federal 1040 or State income tax return, of which must be from the most recent tax year, name employee as person filing, and name of domestic partner listed as dependent with relationship of “Other” (Only the page listing filing status and exemptions is required-see sample. E-Files are not accepted)
• Utility bill  
• Document from bank account or financial institution

Download Domestic Partner Rate Sheet

Download Domestic Partner Affidavit

Download Tax Status Declaration

• Insurance document such as homeowner, renter or automobile  
• Mortgage document or current lease  
• Valid vehicle registration  
Eligibility Requirements Acceptable Supporting Documentation
For child up to age 26 submit one document – Submit a copy of one document from Proof E
Children up to age 26 Eligible children include a natural child, legally adopted children, a stepchild; child of a domestic partner (employee must be covering domestic partner); or any other child for whom you have legal guardianship or court-ordered custody. Proof E
  • A Federal or State income tax return from most recent tax year that list your dependent with the relationship as your daughter, son, or child • Final divorce decree, parental custody agreement or Qualified Medical Child Support Order (QMCSO), which must contain the name of the employee or spouse indicating parentage of the child, contain the name of the child, official signature or stamp indicating document has been filed
These children are eligible regardless of tax dependency, marital or student status. • Child’s legal or hospital birth certificate or affidavit of parentage, which must contain the first and last name of employee or spouse*, contain the name of the child, and indicate date of birth • Legal adoption, guardianship or legal custody papers, which must contain the name of the employee or spouse, contain the name of the child, official signature or stamp indicating document has been filed
  • Legal household/family registry, must show relationship  
  (This is only acceptable if the child was born outside the U.S. and you have no legal birth certificate.)  
  *Also required to prove the relationship between you and your stepchild: If you are an employee providing documentation for a child of your legal spouse, HR must receive the required proofs listed for Spouse (Proof A and B), even if you do not currently cover your spouse.

Disabled Dependents


Dependent Children Over 26

If you have a dependent child enrolled in a plan who is under the age of 26 and totally disabled, either mentally or physically, that child’s health coverage may continue past the age of 26 if UMR certifies the child as totally disabled. Benefits will automatically end at the end of the month that the dependent turns 26 if the dependent has not been certified as totally disabled.

Notifying UMR of Disabled Dependents

It is your responsibility to notify UMR that your dependent is disabled and provide UMR all requested initial documentation either prior to the dependent turning 26 or within 30 calendar days after the day coverage for the dependent would normally end as a result of turning 26. UMR may ask for additional documentation for proof of being totally disabled in accordance with the plan guidelines. Failure to submit requested documentation within the allotted timeframe may result in loss of coverage for the dependent.

UMR Certified Dependents

If UMR certifies the dependent as totally disabled after coverage has ended, the coverage will be restored to the first day coverage ended. Once a disabled dependent over the age of 26 has been voluntarily or involuntarily removed from a Valleywise Health plan, they cannot be added back onto a plan under any circumstance.

Online enrollment for full-time and part-time benefit eligible employees must be completed within 30 days from the date of employment or date of status change to a benefit eligible position.

Once the online enrollment has ended, no changes are allowed. The next opportunity to elect benefit coverage is during the next Annual Enrollment period, or during a Qualifying Life Event.