Eligibility for coverage

In general, you may enroll in health and insurance benefits described on this site if you are a non-union U.S.-based employee (including those currently on LTD) of the wholly owned U.S. subsidiaries of Merck & Co., Inc. and U.S.-based employees of Merck Sharp & Dohme LLC who are covered by collective bargaining agreements other than those who are members of the United Steelworkers Union Local 10-00086.

You may enroll your spouse/domestic partner, children (including your partner’s children) up to age 26 and eligible disabled children up to any age in many of Merck’s health and insurance plans. It is important to confirm any covered dependents continue to meet the eligibility requirements as outlined below, under “Eligible dependents.”

• Your spouse: The person recognized as your current legal spouse under statutory or common law of the United States. Note: An ex-spouse is not eligible to be covered as an eligible dependent under the terms of the plans, even if there is a court order requiring you to provide health benefits coverage to your ex-spouse.
  

• Domestic partner: A person, of the same or opposite sex, with whom you share an ongoing, exclusive, emotionally-committed relationship (and intend to do so indefinitely) and within this domestic partnership, you both meet all of the following criteria:
  • Are at least age 18 and mentally competent to enter into a legal contract
  • Are not related by blood or adoption to a degree closer than permitted by state law for marriage
  • Are not married to another person under statutory or common law of the United States nor in a domestic partnership with another person
  • Are jointly responsible for each other’s welfare, financial and other obligations, and
  • Reside together in the same household — and have done so for at least 12 months.
    
    Note: The definition of domestic partner under life insurance differs. Refer to the Life Insurance SPD for more information.

• Your children, up to the end of the month in which they reach age 26. Children mean your:
  • Biological children
  • Stepchildren, including your spouse’s/domestic partner’s biological children, foster children, legally adopted children and children for whom your spouse/domestic partner is legal guardian
  • Foster children – Legally adopted children (eligibility begins on the date of placement for adoption or commencement of legal obligation to provide support in anticipation of adoption)
  • Children for whom you are legal guardian, and
  • Children for whom coverage is required by a Qualified Medical Child Support Order (QMCSO).

If your dependent child is physically or mentally disabled, coverage for your child may continue beyond age 26, provided your child’s disability begins before the date your child reaches the age at which coverage would otherwise end. Contact your medical plan administrator or call the Benefits Service Center for more information.

If your dependent is no longer eligible

If your dependent does not currently meet the eligibility requirements for coverage or becomes ineligible in the future (for example, you and your spouse get divorced), you must contact the Benefits Service Center immediately to be sure coverage for your dependent is terminated.

Dependent audit

If you add a new dependent to medical coverage, you will receive a letter or email from HMS, a Gainwell Technologies Company (an independent third-party vendor designated by Merck to conduct dependent eligibility verifications), requesting documentation to verify your dependent’s eligibility (e.g., birth certificate, marriage certificate, domestic partnership affidavit, etc.). Failure to respond or provide all required documentation will result in the removal of your dependent(s) from any company-sponsored benefits in which they are currently enrolled and COBRA coverage will not be offered.

The company, in its sole discretion, maintains the right to audit any and all dependent information on file at any time.