Forms

Dental plan change form

(CAN ONLY SWITCH PLANS STARTING FALL TERM)

Domestic Partner Affidavit

Want to add your partner 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.

I will also need the partners: full name, DOB, SSN (if they have one), and gender.  You can send that to Glenn securely via your UO Microsoft OneDrive account to benefits@gtff.net or call and leave message at 541-344-0832 x1.


If you have questions, you can contact Glenn Morris, our health care administrator, at (541) 344-0832 or via email at benefits@gtff.net.