Eligibility

Benefits eligibility is determined based on the amount of standard hours you work per week. Standard hours are the number of hours associates are scheduled to work per week, as maintained in Workday. Standard hours may not be reflective of actual hours worked in a given week.

Eligible dependents include:

• Your spouse or domestic partner
• Dependent children who are married or unmarried — including adopted children, foster children in your care, and stepchildren. Children are eligible from the day they are born, adopted, or placed with you as a foster child until the end of the month of their 26th birthday
• Your domestic partner’s biological or adopted children who reside with you until the end of the month of their 26th birthday
• Other minor children if you’re their legal guardian
• Older children with mental or physical impairments may be eligible — certifications must be provided (as applicable) Learn more

Ineligible dependents include, but are not limited to:

• Divorced spouses — if you’re legally required to provide medical coverage for your divorced spouse, you must purchase individual coverage outside of the Capital One plans
• Parents, grandparents, siblings, aunts, uncles, and cousins — are not eligible under any circumstance
• Spouses of your dependent children

Proof of Eligibility

You may be required from time to time to provide proof of your dependents’ eligibility upon request. False or misrepresented eligibility information may cause both your coverage and your dependents’ coverage to be irrevocably terminated (retroactively to the extent permitted by law), and could be grounds for employee discipline — up to and including termination. Failure to provide timely notice of loss of eligibility will be considered intentional misrepresentation. If your coverage is terminated retroactively due to fraud or misrepresentation, you will forfeit any contributions made.

Eligible associates may enroll their domestic partner for medical, dental, vision, and life and AD&PL insurance coverage.

A domestic partner is a person of the same or opposite gender as you, with whom you share your life. To be eligible, you and your domestic partner must both be at least 18 years of age and not related by blood. You and your domestic partner must satisfy these requirements:

• You are each other’s sole domestic partner and intend to remain so indefinitely
• You reside in the same residence
• You are financially interdependent
• You are not legally married to anyone else

You also may cover your domestic partner’s biological or adopted children if:

• You cover your domestic partner
• The children are under age 26. Older children with mental or physical impairments may be eligible — certifications must be provided (as applicable) Learn more
• They live in your household

Based on IRS rules, you can generally make changes during the year only if you have a qualifying change in your family or employment status, known as a qualifying life event. This includes events such as:

• A change in legal marital status (marriage, divorce, legal separation, annulment or death of a spouse);
• A change in the number of dependents as a result of birth, adoption, change in guardianship, death, and establishment or dissolution of a domestic partnership;
• A change in employment status for you, your spouse, domestic partner or dependent (such as termination or commencement of employment; commencement of or return from an unpaid leave of absence);
• A gain or loss of coverage outside of Capital One's Health and Welfare plans;
• A change in place of residence for you, your spouse/domestic partner or dependent, where the change affects your access to the benefit, such as moving outside of the United States or moving to the United States from another country;
• A change in eligibility for coverage as a result of a judgment, decree or order (including a Qualified Medical Child Support Order); or
• Any event that causes a dependent to satisfy or cease to satisfy the requirements for coverage as specified in the plan(s).

View more details on these qualified life events.

Changes to your benefits enrollment must be consistent with the eligible life event (i.e. the effective date of the benefits change must be the same as the date the life event and gain or loss of coverage has occurred, and the changes allowed to your coverage is representative of the gain or loss of coverage).

Changes must be made through the Benefits Application through Workday or by contacting the HR Benefits Center at 1-888-376-8836 within 31 days of the event (60 days after birth, adoption of a child, or loss or gain of eligibility for a state/federal insurance program such as Medicaid or the Children's Health Insurance Program (CHIP)). If you don't complete your enrollment within this timeframe, you must wait until the next benefits Open Enrollment period to make updates. If you are already enrolled in a health plan, please note that you will not be able to change plans during the year through a QLE.

The Patient Protection and Affordable Care Act (the Health Care Reform law) requires employers with 100 or more employees to offer affordable health care coverage to full-time employees who work an average of 30 or more hours per week.

Capital One eligibility guidelines already meet — and exceed — this requirement. We’re including additional measures to ensure all associates who could meet the eligibility criteria set forth by the law are eligible for our health benefits.

If you’re a part-time associate regularly scheduled to work fewer than 20 standard hours per week as maintained in Capital One’s system of record (Workday), you are typically ineligible for benefits. However, if you meet the required average of 30 “hours of service” per week as defined by the Health Care Reform regulations, you may be eligible for health benefits (except Short-Term Disability). We’ll monitor service hours to ensure eligible associates receive benefits.