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.
In-Network Health Services Learn how much it will cost to visit the doctor, have labs drawn, get an X-ray and more. Program Option State Employee and Retiree Health Plan & Supplemental Benefits Plan Year 2025
ET-1900 Local Employer IAS Local Employer Engagement Forum Questions & Answers This information represents the state of the Insurance Administration System project at the time of the meeting.
Breakdown of Your Costs by Medicare Plan Design Lists the costs of common health services for each plan design. Plan Year 2025 Program Option Local Traditional Health Plan (PO12) & Supplemental Benefits
Breakdown of Your Costs by Medicare Plan Design Lists the costs of common health services for each plan design. Plan Year 2025 Program Option Local High Deductible Health Plan (PO17) & Supplemental Benefits
Breakdown of Your Costs by Medicare Plan Design Lists the costs of common health services for each plan design. Plan Year 2025 Program Option Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
Breakdown of Your Costs by Medicare Plan Design Lists the costs of common health services for each plan design. Plan Year 2025 Program Option Local Health Plan (PO16) & Supplemental Benefits
Breakdown of Your Costs by Medicare Plan Design Lists the costs of common health services for each plan design. Plan Year 2025 Program Option State Employee and Retiree Health Plan & Supplemental Benefits
Breakdown of Your Costs by Medicare Plan Design Lists the costs of common health services for each plan design. Plan Year 2025 Program Option Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
Breakdown of Your Costs by Medicare Plan Design Lists the costs of common health services for each plan design. Plan Year 2025 Program Option Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits