Hawaii Employer-Union Health Benefits Trust Fund

EVENT DESCRIPTION: Retiree wishes to add newborn to plans

WHEN EC-2/EC-2H MUST BE SUBMITTED TO EUTF: Within 180 days from event date

DOCUMENTATION REQUIRED TO BE ATTACHED TO EC-2/EC-2H: Birth certificate and Social Security Number must be submitted with EC-2/EC-2H and within 180 days from event date. Hospital certificate is acceptable as a temporary supporting document while awaiting birth certificate.

EFFECTIVE DATE: Retiree can choose: birth date, beginning of the next pay period after birth date, or beginning of 2nd pay period after birth date

CAN I CHANGE PLANS?: No plan changes allowed if already enrolled. May enroll in plans if not already enrolled or may add dependents if already enrolled.