ET-1907
Form Local Employer / State Employer

No Taxpayer Identification Number

A tool for an employer to confirm information was presented to a new employee, due dates identified and appropriate information and forms supplied for all ETF-administered benefits offered by the employer.

ET-2533
Form Local Employer / State Employer

Employee Transaction Report

Employers may be required to report prior year adjustments to employee hours, earnings or employee-paid required contributions by completing and submitting this report.

A lock over a data screen of 0s and 1s.

Privacy and Policy Notices

We are committed to following legal policy and protecting the privacy of all members and visitors to our website. Please read our policy statements to understand how we protect the information that we collect, use, and share.

COBRA: Continuation of Coverage Rights for the Group Health Insurance Program

Program Option
  • 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