Hawaii Employer-Union Health Benefits Trust Fund

EVENT DESCRIPTION: Employee wishes to add newborn to EUTF plans

WHEN EC-1/EC-1H MUST BE SUBMITTED TO EMPLOYER (Personnel Office): Within 180 days of event date

DOCUMENTATION REQUIRED TO BE ATTACHED TO EC-1/EC-1H: Birth certificate and Social Security Number must be submitted with EC-1/EC-1H and within 180 days from event date. Hospital certificate is acceptable as a temporary supporting document while awaiting birth certificate.

EFFECTIVE DATE: Employee can choose: The Event Date, the first day of the pay period following the Event Date or the first day of the 2nd pay period following the Event Date

CHANGES ALLOWED TO PLANS?: No plan changes allowed if already enrolled. May enroll in plans if not already enrolled or may add dependents to current plans if already enrolled.