New Domestic Partner

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

EVENT DESCRIPTION: Employee wishes to enroll new domestic partner in EUTF plans

WHEN EC-1/EC-1H MUST BE SUBMITTED TO EMPLOYER (Personnel Office): Within 45 days from date of notarized signature (event date is considered date of notarization)

DOCUMENTATION REQUIRED TO BE ATTACHED TO EC-1/EC-1H*: Notarized Declaration of Domestic Partnership, Affidavit of Dependency (notarized if IRS qualified) and two sets of documents must also be provided which include any combination of documents that list both you and your domestic partner’s name and address or separate documents from each party with the same address (i.e. utility bill, bank statement, rental agreement, etc.). The verification documentation is in addition to the required declaration and affidavit, along with the EC-1/EC-1H form.

If adding Dependents:

  • 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: Employee can choose: Date of notarization of Declaration of Domestic Partnership, beginning of next pay period after notary date, or beginning of 2nd pay period after notary date

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.