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-8948
Active Employee / Retiree / Local Employer / State Employer

Uniform Dental Benefit Fact Sheet

The Uniform Dental Benefit (UDB) is intended to provide dental coverage for preventive, basic and diagnostic services.

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.

25ET-2180
Brochure Active Employee / Retiree / Other Benefit Recipient / Local Employer / State Employer

2025 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.

Video
7 minutes
Confused person trying to pick a health plan

Choosing a Plan Design

Not sure where to start when deciding on a health plan? This video will walk you through the first step: choosing a plan design. The video shows the key differences between your options and case studies show how different plan designs would affect a participant’s budget over 3 years.

You Have a New Dependent

Experiencing this life event may allow you to make changes to your accident plan or health, dental, vision, or long-term care insurance.

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

Transit Account

A Transit Account allows you use pre-tax dollars to pay for eligible mass transit expenses related to your commute to and from work.

Plan Year
  • 2025
Program Option
  • 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.

Data Analytics and Insights

Data Analytics and Insights (DAISI) is a data warehouse and analytics tool administered by Merative. All the organizations that supply health and wellness products and services as part of the Group Health Insurance Program put data into DAISI through a secure file transfer process. DAISI organizes and protects this data and has tools to help make sense of the data.