ET-2384 Form Active Employee / Local Employer / State Employer Employee Reimbursement Accounts (ERA) Enrollment For UWs use only, as a paper alternative for a member who cannot complete their ERA enrollment online.
24ET-2168 Brochure Active Employee / Retiree / Local Employer 2024 Health Benefits Decision Guide: Local Health Plan Insurance for Employees and Retirees 2024 local health plan group health benefits decision guide for local employees and retirees.
25ET-2158 Brochure Active Employee / Retiree / Local Employer 2025 Insurance Benefits Decision Guide: Local Deductible Plan Insurance for Employees and Retirees 2025 local deductible plan insurance benefits decision guide for local employees and retirees.
25ET-2168 Brochure Active Employee / Retiree / Local Employer 2025 Insurance Benefits Decision Guide: Local Health Plan Insurance for Employees and Retirees 2025 local health plan insurance benefits decision guide for local employees and retirees.
25ET-2169 Brochure Active Employee / Retiree / Local Employer 2025 Insurance Benefits Decision Guide: Local HDHP Insurance for Employees and Retirees 2025 local high deductible health plan insurance benefits decision guide for local employees and retirees.
24ET-2158 Brochure Active Employee / Retiree / Local Employer 2024 Health Benefits Decision Guide: Local Deductible Plan Insurance for Employees and Retirees 2024 local deductible plan group health benefits decision guide for local employees and retirees.
24ET-2169 Brochure Active Employee / Retiree / Local Employer 2024 Health Benefits Decision Guide: Local HDHP Insurance for Employees and Retirees 2024 local high deductible health plan group health benefits decision guide for local employees and retirees.
ET-2301 Form Active Employee / Local Employer / State Employer Health Insurance Application/Change Form Enroll in health insurance or change your coverage.
Health Plan and Vendor Contact Information Find the address, phone number, and other contact details for health plans and vendors. Program Option Local Annuitant Health Program (LAHP) Local Deductible Health Plan (PO14) & Supplemental Benefits Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits Local Health Plan (PO16) & Supplemental Benefits Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits Local High Deductible Health Plan (PO17) & Supplemental Benefits Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits Local Traditional Health Plan (PO12) & Supplemental Benefits Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits State Employee and Retiree Health Plan & Supplemental Benefits
ET-2311 Form Active Employee / Local Employer / State Employer COBRA Continuation - Conversion Notice Under federal law, known as COBRA, you and your qualified beneficiaries may continue group health insurance coverage, if eligible.