All EUTF Forms
Active Employees
Reference
Active Reference Guide |
Death Checklist |
New Hire Enrollment Guide |
Newborn Checklist |
Open Enrollment Checklist |
Payment of Health Benefits Premiums
ACH Deduction Authorization Agreement Form |
ACH Deduction Cancellation Form |
Enrollment/Update Your Info
Administrative
Administrative Rules |
Affidavit for Collection of Personal Property |
Appeal Form |
Chapter 87A |
General Affidavit |
HSTA VB – only available to those who are currently enrolled in HSTA VB plans (formerly VEBA Members)
2020-21 EC-1H Enrollment Form for HSTA VB |
Future Retirees
Reference
2021 Retiree Highlights Guide |
Death Checklist |
Department of Education (DOE) Retirement Checklist |
Medicare Checklist |
Pre-Retirement Checklist |
Medicare Part B Reimbursement
Direct Deposit Agreement Form |
Payment of Health Benefits Premiums
Enrollment/Update Your Info
Administrative
Administrative Rules |
Affidavit for Collection of Personal Property |
Appeal Form |
Chapter 87A |
General Affidavit |
Retirees
Reference
2021 Retiree Highlights Guide |
Death Checklist |
Medicare Checklist |
Medicare Part B Reimbursement
Direct Deposit Agreement Form |
Payment of Health Benefits Premiums
Enrollment/Update Your Info
Administrative
Administrative Rules |
Affidavit for Collection of Personal Property |
Appeal Form |
Chapter 87A |
General Affidavit |
Forms Index
Forms & Documents Index
Sample Documents