Loss of Coverage
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EVENT DESCRIPTION: Employee and/or dependent loses health coverage and wishes to enroll in EUTF or HSTA VB plans
WHEN EC-1/EC-1H MUST BE SUBMITTED TO EMPLOYER (Personnel Office): Within 45 days of loss of coverage
DOCUMENTATION REQUIRED TO BE ATTACHED TO EC-1/EC-1H*: Letter from previous employer or carrier detailing type of coverages lost (i.e. medical, drug, dental, vision), date of loss of coverage, names of any covered dependents. Birth certificate, student certification (if applicable), and Social Security Number if adding any dependent children, marriage certificate if adding spouse within 45 days of loss of coverage.
EFFECTIVE DATE: The first day following the day non-EUTF coverage was lost.
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. If proof document notification date is outside of the initial 45-day enrollment period, the employee will be given 45-days from the notification date to submit EC-1/EC-1H form and required documents. Those losing coverage from a Medicaid plan have 60 days from event date to submit EC-1/EC-1H form and required documents. The effective date of coverage will be the day following the day non-EUTF coverage was lost.