New Domestic Partner

Domestic Partnership Enrollment - Retirees(Watch video on Domestic Partnership Enrollment)

EVENT DESCRIPTION: Retiree wishes to enroll new domestic partner in EUTF or HSTA VB plans

WHEN EC-2/EC-2H MUST BE SUBMITTED TO EUTF: Within 45 days from date of notarized signature (event date is considered date of notarization)

DOCUMENTATION REQUIRED TO BE ATTACHED TO EC-2/EC-2H: Notarized Declaration of Domestic Partnership and Affidavit of Dependency (notarized if IRS qualified). Forms available on the EUTF website.

Copy of Partner’s Medicare card showing Part B and letter from Social Security, if eligible to enroll. DDA form if retiree is not Medicare eligible yet.

If adding Dependents:

  • Birth certificate and Social Security Number
  • If enrolling a dependent age 19 through 23, 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 date the notary signs the Declaration of Domestic Partnership, the first day of the first pay period after the notary signs, or the first day of the 2nd pay period after the notary signs

CAN I CHANGE PLANS?: No plan changes allowed if already enrolled. May enroll in plans if not already enrolled or may add dependents if already enrolled.