The Employee Reimbursement Accounts (ERA) Program is an optional benefit that allows participants to use pre-tax dollars to pay for certain Internal Revenue Service-approved expenses.
Active Employee /
Retiree /
Board Member /
Local Employer /
State Employer
Employees who did not enroll for group life insurance coverage during their initial enrollment period, or insured employees who wish to apply for more insurance for themselves or their spouse or dependents, may apply using this form.