Dependent coverage and pricing
Add spouse, domestic partner, or children under 26.
Many employers ask about covering employees' family members on their MEC plan. Benefi offers dependent coverage for spouses, domestic partners, and children up to age 26. Here's how it works and what employers need to know about pricing and enrollment.
Who qualifies as a dependent
Benefi recognizes three categories of dependents across both Essential and Plus plans:
- Spouse (legally married)
- Domestic partner (based on your company's definition)
- Children up to age 26 (biological, adopted, step-children)
The age 26 cutoff aligns with ACA requirements. Children remain eligible through the month they turn 26, regardless of student status, marital status, or financial dependency. Your company's existing dependent eligibility rules typically carry over to the Benefi plan.
Domestic partner coverage
Both Essential and Plus plans support domestic partner coverage. Your company defines what constitutes a domestic partnership (common-law marriage, affidavit requirements, etc.). Benefi follows your existing HR policies.
Coverage tiers and pricing structure
Benefi uses a standard four-tier structure for dependent pricing:
| Coverage tier | Who's covered |
|---|---|
| Employee only | Just the employee |
| Employee + spouse | Employee and spouse/domestic partner |
| Employee + children | Employee and all eligible children |
| Family | Employee, spouse/partner, and all children |
Monthly rates increase with each tier. Your specific dependent rates are calculated during quoting based on your workforce demographics and selected plan level. Most employers subsidize a portion of dependent costs, though the subsidy level varies by company.
How dependents enroll
Employees add dependents through their Benefi account during initial enrollment or any time after. The process works like this:
Employees enter basic dependent information (name, date of birth, relationship) directly in the app. No paperwork moves between HR and Benefi. Dependents appear on the employee's account immediately and can start using benefits right away.
For newborns or newly adopted children, employees have 30 days to add them. Marriage or domestic partnership also triggers a 30-day special enrollment window.
What dependents can access
Dependents get the same benefits as the employee. On the Essential plan, that means 24/7 Virtual Primary Care, 500+ $0 generic medications, and mental health therapy sessions. Plus plan dependents also receive the in-person visit allowances.
Each dependent uses their own login credentials for privacy. Parents manage accounts for minor children. The $0 prescription formulary applies equally to all covered family members, and copays for Plus plan visits are the same for dependents and employees.
Key takeaways
- Dependent eligibility includes spouses, domestic partners, and children up to 26
- Four coverage tiers let employees choose their coverage level
- Dependents enroll through the employee's account with immediate access
Frequently Asked Questions
Can employees add dependents after their initial enrollment?
Yes, employees can add eligible dependents at any time through their Benefi account, not just during initial enrollment. For qualifying life events like marriage, birth, or adoption, employees have a 30-day window to add the new dependent. Once added, dependents have immediate access to benefits and receive their own login credentials.
Do dependents need separate ID cards or can they use the employee's?
Each dependent gets their own login credentials for privacy and direct access to Virtual Primary Care and other benefits. For in-person visits on the Plus plan, dependents use the same network and identification process as the employee. Parents manage accounts for minor children under 18.
What happens to dependent coverage if the employee leaves the company?
Dependent coverage ends when the employee's coverage terminates. The timing follows your company's standard termination policies. COBRA continuation coverage may be available depending on your employer size and plan design - employees should check with HR about COBRA eligibility for both themselves and their dependents.
Are stepchildren and adopted children treated the same as biological children?
Yes, Benefi covers all children up to age 26 equally regardless of whether they are biological, adopted, or stepchildren. The same age 26 cutoff applies to all, and they remain eligible through the month they turn 26. No additional documentation is required for stepchildren beyond what your company's HR policies require.
How much do employers typically contribute toward dependent premiums?
Dependent contribution levels vary significantly by employer. Some companies pay the full cost for dependents, others require employees to pay the full dependent premium, and many fall somewhere in between. Your specific dependent rates and any employer contribution amounts are determined during the quoting process based on your company's budget and benefits strategy.