Eligibility and participation

Learn about the eligibility rules governing the Medical Program

Who is eligible

You are eligible to participate in the Medical Program if you are classified as a full-time, part-time or temporary employee of a participating employer. Occasional employees are only eligible to access the Employee Assistance Program (EAP).*

An eligible U.S. employee on international assignment outside of the U.S. is eligible for the Expatriate Medical Plan administered by Cigna, which includes the HealthPlus PPO Option of the BP Medical Program. In this case, you do not make a separate election to enroll in the HealthPlus Option. If you have questions, contact Cigna or the BP Benefits Center for more information.

Full-time employee: An employee assigned a position that:

  • Requires full-time service as determined by BP;
  • Is established to fill regular and ordinary employment requirements; and
  • Is expected to continue for an indefinite period of time.

Part-time employee: An employee assigned a position that is:

  • Regular and ordinary in nature;
  • Expected to continue for an indefinite period of time; and
  • One in which the employee works a schedule that is less than that of a full-time employee but is at least 20 hours a week.

Temporary employee: An employee assigned to a position that:

  • Requires full-time or part-time (not occasional) service as determined by BP;
  • Requires a regular schedule of hours; and
  • Will continue for a specified period of time or until the occurrence of a specified event, such as the return to work of a regular employee or the completion of a special assignment or project.

Interns and co-ops are considered occasional employees.

* Occasional employee: For purposes of the plan, an "occasional employee" means an employee who is employed by BP for work that is irregular or infrequent in nature and which ordinarily should last no longer than four to six months, or an employee who works a regular schedule that is less than 20 hours per week and which is expected to continue for an indefinite period of time.

Eligible dependents

If you participate in the BP Medical Program, you may also enroll your eligible dependents under your medical coverage. Eligible dependents include your:

  • Spouse, including a legally separated spouse.
  • Common-law spouse (if you and your common-law spouse reside in a state that recognizes your common-law marriage as a legal marriage).
  • Opposite-sex or same-sex domestic partner.
  • Eligible dependent child.

Except for COBRA continuation and a surviving disabled dependent (as described below), you must participate in the Medical Program for your dependents to also be eligible.

An "eligible dependent child" is a child up to age 26* if he/she is:

  • Your natural or adopted child (including a child placed with you for adoption);
  • A child for whom you have legal guardianship;
  • A child of your spouse/domestic partner; or
  • A grandchild who lives with you in a regular parent/child relationship for at least half the year and receives at least 50% of his/her financial support from you. This includes only a grandchild related to you by blood, marriage or domestic partnership whose parents do not live with the child and for whose daily care and guidance you are legally responsible. 

* An eligible covered child who is totally and permanently disabled at the time he/she turns age 26 can continue to be covered as long as approved by the claims administrator.

Disabled Dependent Children

Health coverage for your fully disabled dependent child may be continued past the maximum age for a dependent child.

Your child is considered fully disabled if: 

  • He or she is not able to earn his or her own living because of mental retardation or a physical disability which started prior to the date he or she reaches the maximum age for dependent children under your plan; and
  • He or she depends chiefly on you for support and maintenance.

Proof that your child is fully disabled must be submitted to the claims administrator no later than 31 days after the date your child reaches the maximum age under your plan.

Coverage will cease on the first to occur of:

  • Cessation of the disability.
  • Failure to give proof that the disability continues.
  • Failure to have any required exam.
  • Termination of dependent coverage as to your child for any reason other than reaching the maximum age under your plan.

The claims administrator will have the right to require proof of the continuation of the disability. The claims administrator also has the right to examine your child as often as needed while the disability continues, at its own expense. An exam will not be required more often than once each year after two years from the date your child reached the maximum age under your plan.

 
Your dependent does not qualify as an eligible dependent if he/she is:
  • On active duty in the military.
  • Covered as a BP employee or retiree in a BP-sponsored medical plan.
  • Covered as a dependent of another BP employee or retiree in a BP-sponsored medical plan.

Special rules apply if your spouse/domestic partner is also an eligible BP employee. You may do either of the following:

  • Each of you may enroll for "You only" coverage if no other dependents are covered.
  • One of you may enroll in a coverage level that includes dependents, with the other covered as one of your dependents. "You only" coverage is not available for the spouse/domestic partner covered as a dependent.
In order for a same-sex spouse to be covered as a spouse under the plan, the marriage must have been conducted in a state that recognizes the legality of your same-sex marriage, and you will have to submit a copy of the marriage license from that state. Note that civil union ceremonies are specifically not permitted to be treated as marriages under federal law. If you participated in a civil union only, your partner must be treated as your domestic partner by the plan, and premiums for him/her must be made on an after-tax basis.

For the EAP, your eligible dependents include any member of your household, regardless of relationship or whether he/she qualifies as an eligible dependent under the BP Medical Program. In addition, a child who does not reside with you is an eligible dependent for the EAP if he/she is enrolled in your BP Medical Program coverage.

Domestic partners

There are two alternative methods for qualifying your same-sex or opposite-sex domestic partner as an "eligible dependent":

  • Alternative "A": Register your domestic partnership or civil union in accordance with registration requirements in the state in which you and your domestic partner or civil union partner reside. Your registration date is the first date you can enroll your partner as a domestic partner under the BP Medical Program; or
  • Alternative "B": Satisfy each of the following requirements for at least six full months before signing a Domestic Partner Affidavit. The date you are first eligible to sign the affidavit is the date your partner will be considered your domestic partner for plan purposes.
    • Be each other's sole domestic partner and intend to remain so indefinitely;
    • Reside together in the same principal residence and intend to remain so indefinitely;
    • Be emotionally committed to one another, share joint responsibilities for the partnership's common welfare and be financially interdependent;
    • Be at least 18 years old, of legal age and mentally competent to enter into contracts;
    • Not be related by blood closer than would bar marriage under applicable law where you live; and
    • Not be legally married to, nor the domestic partner of, anyone else.

Note: Some HMOs may impose more restrictive criteria. Contact the HMO directly for more information. Also, under the Medical Plan, and pursuant to federal law, a civil union must be treated by the plan the same as a domestic partnership.

Your domestic partner will cease being an eligible dependent as of the date you cease to satisfy any of the above conditions. If your domestic partnership ends, call the BP Benefits Center immediately.

 

Publication date: April 2019

 

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