Hawaii Employer-Union Health Benefits Trust Fund

EVENT DESCRIPTION: Employee must terminate domestic partner and domestic partner’s dependents

WHEN EC-1/EC-1H MUST BE SUBMITTED TO EMPLOYER (Personnel Office): Within 45 days of termination of partnership, however, it will be accepted and processed regardless of when form is received.

DOCUMENTATION REQUIRED TO BE ATTACHED TO EC-1/EC-1H: Declaration of Termination of Domestic Partnership

EFFECTIVE DATE: Coverage ends the first day of the 1st pay period following the date of termination of the domestic partnership.

CHANGES ALLOWED TO PLANS?: No