Loss of Coverage

Loss of Coverage(Watch video on Loss of Coverage)

EVENT DESCRIPTION: Employee and/or dependent lost coverage from a non-EUTF plan, and wishes to enroll in EUTF plans

WHEN EC-1/EC-1H MUST BE SUBMITTED TO EMPLOYER (Personnel Office): Within 45 days from loss of other coverage

DOCUMENTATION REQUIRED TO BE ATTACHED TO EC-1/EC-1H*: Loss of coverage letter from previous employer/carrier detailing type of coverages lost (i.e., medical, dental, drug, vision), date of loss of coverage, and names of any covered dependents.

If adding Dependents:

  • Spouse or Partner:
    • Marriage, Civil Union certificate or Domestic Partnership documents and Social Security Number, if not previously submitted to the EUTF
  • Dependent Child:
    • Birth certificate 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: Day following loss of coverage from other plan

CHANGES ALLOWED TO PLANS OR TO ENROLL IN PLANS OR ADD DEPENDENTS?: No plan changes allowed if already enrolled. May enroll in plans if not already enrolled or may add dependents if already enrolled.