Court Order (aka Qualified Medical Child Support Order – QMCSO)

EVENT DESCRIPTION: To cover eligible dependent

WHEN EC-1/EC-1H MUST BE SUBMITTED TO EMPLOYER (Personnel Office): EUTF receives the order directly from the Child Support Enforcement Agency (CSEA). No EC-1/EC-1H is required if employee is already enrolled in plans. If not enrolled, employee has 45 days from the event date to submit an EC-1/EC-1H to select plan option(s). If EC-1/EC-1H is not received within 45 days, employee and child(ren) will be added to the lowest cost PPO plan.

DOCUMENTATION REQUIRED TO BE ATTACHED TO EC-1/EC-1H: Birth certificate if enrolling a child for the first time in EUTF plans, and Social Security Number.

If enrolling a dependent age 19 through 23 in Dental and/or Vision coverage, student certification from an accredited school/college on school letterhead with registrar’s signature confirming full-time status or an enrollment certificate from the National Student Clearinghouse. Transcripts not accepted.

EFFECTIVE DATE: The Event Date

CHANGES ALLOWED TO PLANS?: Plan changes allowed if required by court order. May enroll in plans if not already enrolled or may add dependents to current plans if already enrolled.