24ET-2180
Brochure Active Employee / Retiree / Other Benefit Recipient / Local Employer / State Employer

2024 Uniform Benefits Certificate of Coverage

This Certificate of Coverage is your Summary Plan Description and contains the Uniform Benefits offered under the Group Health Insurance Program.

ET-2123
Brochure Active Employee

Additional Contributions

This brochure describes the type of additional contributions that you can make, the benefits of making these contributions and the restrictions that apply.

ET-2545
Form Active Employee

Additional Contributions Remittance

If you choose to make voluntary additional employee paid contributions, complete and return this form with your payment.

ET-2815
Form Retiree / Other Benefit Recipient

Address/Name/Gender Change

Update your name, address, or gender or address on file with ETF.

ET-4943
Brochure Active Employee / Retiree / Other Benefit Recipient

Administrative Appeal Process

This brochure is designed to assist you in understanding the administrative appeals process as it relates to ETF. It is not intended to substitute for the legal advice or assistance of an attorney.