Health and Welfare Plan Eligibility

Your eligibility for Capital One’s Health and Welfare plans is based on your employment status. Your Health and Welfare benefits include medical, dental, vision, and life insurance and AD&PL as well as supplemental disability plans, Vacation/PTO Buy-Up and flexible spending accounts.

  • If you’re a full-time associate, you're eligible for most of your Capital One benefits on your date of hire.
  • If you’re a part-time associate (regularly scheduled to work from 20 to 32 hours per week as maintained in Capital One's system of record, Workday), you’re eligible for Capital One health benefits (except Short-Term Disability) after 90 days of employment.
  • If you’re rehired any time by Capital One as a part-time associate, you must have completed 90 days of full-time or part-time service before your original departure to be eligible for health benefits on date of rehire.

Note: Contractors (e.g., leased employees, independent contractors and other workers who are not classified as employees by Capital One), temporary associates, interns and similar categories of workers are not eligible for Capital One benefits, such as health and welfare, retirement and leave and time off benefits.

A complete listing of eligibility for all benefit programs can be found on Pulse. Note: Vacation Buy-up is only available in your first full calendar year of employment assuming that you enroll during Open Enrollment in the prior year. Associates must meet a 90 day waiting period before using PTO, Vacation, and many time off benefits.

Select a topic below to find additional eligibility information.

STANDARD HOURS

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.

Dependents

Eligible dependents include:

  • Your spouse or domestic partner
  • Dependent children that 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 a legal guardian
  • Older children with mental or physical impairments may be eligible–certifications must be provided (as applicable). Click here to 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 dependent children
Domestic Partner

Eligible associates may enroll their domestic partners 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 for domestic partner coverage, you and your domestic partner must:

  • Be at least 18 years of age
  • Not be related by blood
  • Be each other’s sole domestic partner and intend to remain so indefinitely
  • Reside in the same residence
  • Be financially interdependent
  • Not be 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).
  • They live in your household
Coverage Changes During the Year

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. This includes events such as:

  • Marriage or divorce
  • Gaining or losing a domestic partner
  • Birth or adoption of a child
  • Death of your spouse or dependent
  • Your spouse ending or starting employment when that affects coverage eligibility
  • You or your spouse changing from full-time to part-time employment status or vice versa, when the change affects coverage eligibility
  • Change in health coverage by your spouse’s employer
  • Loss of eligibility for your dependent because of exceeding the age eligibility requirements
  • Loss or gain of eligibility (for you or your eligible dependents) for another group health plan
  • Loss or gain of eligibility or a state/federal insurance program such as Medicaid or the Children’s Health Insurance Program (CHIP)
  • Cost increase of 15% or more in another employer’s plan affecting spouse/domestic partner/dependent

Benefit changes must be consistent with the eligible life event. You must make changes through the Capital One online enrollment system or by contacting the Capital One 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, you must wait until the next benefits Open Enrollment period to make updates.

IMPORTANT

All eligible associates, including part-time associates, must enroll in benefits within 31 days of date of hire.

EMPLOYER SHARED RESPONSIBILITY (ESR)

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) after 90 days of employment. We’ll monitor service hours to ensure eligible associates receive benefits.