Please send all 2026 enrollment forms and supporting documents to enrollment@tehw.org

• New Hire Enrollment

  New Hire Enrollment Form

  Green Authorization Card

  Universal Opt-Out Form

  Spousal Credit Form

  Notice of Privacy Practices

• Open Enrollment

  Affidavit of Domestic Partnership Form

  Affidavit of Termination of Domestic Partnership Form

  Disability Certification for Over-age Dependents Form

  2026 Enrollment Change Form – Retiree

  2026 Enrollment Change Form – Active

  SPOOT Form Revised

  SPOOT Form Revised for Dependent Child

• Retiree

  Retiree Enrollment Form

  Retiree Change of Address Form

  Retiree Dental Election Form

• Short Term Disability

  2025 Short Term Disability Application (DC)

  2025 Short Term Disability Application (MD)

  2025 Short Term Disability Application (VA)

• Long Term Disability

  Long Term Disability – The Hartford Benefit Plan

  Long Term Disability – Metlife Application