Common use of Application and Terms Clause in Contracts

Application and Terms. In order to receive any benefit provided for by this Section, an employee and his or her domestic partner shall complete, have notarized and file with the District a Declaration of Domestic Partnership as specified. The employee shall also file with the District a signed Statement of Financial Liability indicating that the employee agrees that they may be required to reimburse the District and/or the District's designated health services plan for any expenditures made by the District and/or the District's designated health plan services for medical claims, processing fees, administrative charges, costs, and attorneys fees on behalf of the domestic partner if any of the submitted documentation is found to be incomplete, inaccurate, or fraudulent. The Statement shall further indicate that the employee agrees to indemnify the District for any loss the District suffers as a result of the employee's failure to file the Notice of Termination of the Domestic Partnership. Employer-paid health care coverage for the domestic partner and dependents is considered taxable income to the employee unless the domestic partner is a dependent as that term is defined by Section 152(a) of the Internal Revenue Code. This benefit coverage is subject to federal income tax and must be reported as imputed income on the employee's Form W-2. The District must pay FICA and FUTA taxes on these amounts and ensure adequate withholding. The non-employee domestic partner does not have rights to continuing coverage under federal law through COBRA or under any state law. The District shall be indemnified by the employee against any legal action pursued by another party under community property or contract or family laws which arises in connection with the employee's use of this provision.

Application and Terms. In order to receive any benefit provided for by this Section, an employee and his or her domestic partner shall complete, have notarized and file with the District a Declaration of Domestic Partnership as specified. The employee shall also file with the District a signed Statement of Financial Liability indicating that the employee agrees that they he or she may be required to reimburse the District and/or the District's ’s designated health services plan for any expenditures made by the District and/or the District's ’s designated health plan services for medical claims, processing fees, administrative charges, costs, and attorneys fees on behalf of the domestic partner if any of the submitted documentation is found to be incomplete, inaccurate, or fraudulent. The Statement shall further indicate that the employee agrees to indemnify the District for any loss the District suffers as a result of the employee's ’s failure to file the Notice of Termination of the Domestic Partnership. Employer-paid health care coverage for the domestic partner and dependents is considered taxable income to the employee unless the domestic partner is a dependent as that term is defined by Section 152(a) of the Internal Revenue Code. This benefit coverage is subject to federal income tax and must be reported as imputed income on the employee's ’s Form W-2. The District must pay FICA and FUTA taxes on these amounts and ensure adequate withholding. The non-employee domestic partner does not have rights to continuing coverage under federal law through COBRA or under any state law. The District shall be indemnified by the employee against any legal action pursued by another party under community property or contract or family laws which arises in connection with the employee's ’s use of this provision.