note: initial enrollment into the GTFF insurance is done in person with Glenn. The form below is if you are currently enrolled in the GTFF plan and want to add someone.
Questions directed to Glenn: <benefits@gtff.net>
Want to add a dependent to the plan? A dependent can be:
- legally recognized spouse*
- domestic partner**
- dependent child(ren)***
- unfortunately, you CANNOT add parents or siblings
You can use this form to add someone:
*A spouse is a legally recognized spouse. You can add your spouse either starting fall term or spring term under our “open enrollment” periods. If you are trying to add a spouse outside of September or March open enrollment periods, there has to be a “qualifying event.” This can be: 1) you got married! 2) your current spouse lost their existing coverage, 3) your spouse was out of the country and re-entered the USA. For qualifying event, I can add partner on the nearest 16th of a month *following* the date of the qualifying event.
**Not married, but have a domestic partner you want to add to your GTFF insurance? You can if you are both:
1) Eighteen (18) years of age or older;
2) Share a close personal relationship and are responsible for each other’s common welfare;
3) Are each other’s sole domestic partner;
4) Are not married to anyone nor have had another domestic partner within the prior 31 days;
5) Are not related by blood closer than would bar marriage in the states of Oregon or Washington;
6) Share the same regular and permanent residence, with the current intent to continue doing so indefinitely;
7) Are jointly financially responsible for “basic living expenses”, defined as the cost of basic food, shelter, and any other expenses of a domestic partner which are paid at least in part by a
program or benefit for which the partner qualified because of the domestic partnership (note: Domestic partners need not contribute equally or jointly to the cost of these expenses
as long as they agree that both are responsible for the cost);
8) Were mentally competent to consent to contract when our domestic partnership began.
You can add your domestic partner either starting fall term or spring term under our “open enrollment” periods. If you are trying to add a domestic partner outside of September or March open enrollment periods, there has to be a “qualifying event.” For domestic partnership, signing the affidavit form attached to the form acts as the qualifying event. I can add domestic partner on the nearest 16th of a month *following* the date the affidavit was signed if it is not done in one of our “open enrollment” months (September or March).
***You can add child(ren) either starting fall term or spring term under our “open enrollment” periods. If you are trying to add a child(ren) outside of September or March open enrollment periods, there has to be a “qualifying event.” Qualifying events can be: 1) you had a baby, 2) You adopted a child(ren), 3) Your child(ren) was out of the USA and re-entered the country, 4) You married someone with dependent child(ren) that lives with you, 5) your domestic partner on the plan has dependent child(ren) that live with you? We can add them!
For birth, coverage begins at the date of birth. For adoption it is when adoption was legally formalized. For the others children’s coverage begins on the 16th of the month following the “qualifying event.”
Always a good idea before you submit form to check in with Glenn. There will be additional cost (e.g., premiums) for adding folks to your coverage.
Dental plan change form
(CAN ONLY SWITCH PLANS STARTING FALL TERM)
If you have questions, you can contact Glenn Morris, our health care administrator, at (541) 344-0832 or via email at benefits@gtff.net.