Employer Dissolves

Understand what happens when your employer dissolves and you become an inactive employee.

Health Insurance Employer Forms

Use the forms on this page to administer the Group Health Insurance program. If you are not finding what you need, go to the Publications page to search through all publications.

ET-1908
Form Local Employer / State Employer

Employer Attestation For Documentation Received

Employers, use this form to verify that you viewed the employee’s original required document(s) to verify the employee or dependent(s) is eligible for benefit coverage, as administered by ETF.

Business people

Update Employer Contact

Need to add, remove, or change your employer’s agent, retirement contact, or insurance contact? Click here for help completing the Designation of Agent (ET-1313) form.

ET-1420
Aug 17, 2020 2:21pm Form Local Employer / State Employer

Employer Agent Responsibilities

This chart explains employer agent responsibilities broken down by on-going, monthly, and yearly.